A local study of radiological findings in children diagnosed with urinary tract infection

Abstract

BACKGROUND: Urinary tract infection (UTI) is a common cause of morbidity in children, requiring investigation to avoid complications. This study aims to:

describe the microorganisms grown on culture according to age at presentation

look for a relationship between abnormal US and/or MCUG results and age and clinical presentation

explore whether an abnormal MCUG was associated with abnormal US

explore whether a DMSA provides additional information to that already given by an US and/or MCUG

METHODOLOGY: All children less than 16 years of age hospitalised for upper or lower UTI, from the 1st January 2019 up till 31st December 2019 were included. Demographics, urine culture and imaging results were collected through the hospital clinical system.

RESULTS: A total of 96 children were included. E. Coli was the commonest causative organism across all ages. 30 children underwent both US and MCUG, whilst 14 underwent US, MCUG and DMSA. Age and clinical presentation did not highlight a statistically significant relationship with abnormal findings on US and/or MCUG. 20% of children had a normal US but an abnormal MCUG. There were no abnormal DMSA results for children with normal combination US and MCUG.

CONCLUSION: MCUG is still warranted in cases of normal baseline US, irrespective of age and gender. Given that our study was not powered enough, it was not possible to ascertain whether DMSA adds additional information in children with a normal US and MCUG. Further studies with larger cohorts are warranted with the aim of reducing DMSA referrals, radiation, and costs.