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Órgano Oficial de la Sociedad
Latinoamericana de lnfectología Pediátrica.
Órgano de la Asociación Mexicana de
Infectología Pediátrica, A.C.
Órgano difusor de la Sociedad Española
de lnfectología

2019, Number 3

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Rev Latin Infect Pediatr 2019; 32 (3)

Extract from the consensus document on diagnosis and treatment of urinary tract infection

Piñeiro PR, Cilleruelo OMJ, Ares ÁJ, Baquero-Artigao F, Silva RJC, Velasco ZR, Martínez CL, Carazo GB, Conejo FAJ, Calvo C

Language: Spanish
References: 30
Page: 88-95
PDF size: 259.09 Kb.


ABSTRACT

Urinary tract infection is defined as the growth of microorganisms in a sterile urine culture in a patient with compatible clinical symptoms. The presence of bacteria without any symptomatology is known as asymptomatic bacteriuria and does not require any treatment. In neonates and infants, fever is the guiding sign to suspect urinary tract infection. Classic urinary tract symptoms become more important in older children. Urine culture collected before starting antibiotics is always required for diagnosis. Clean-catch (midstream) sample should be collected for urine culture. In case of non-toilet-trained children, sample must be obtained by urethral catheterization, or suprapubic puncture in neonates and infants. Samples collected by urine bag should not be used for urine culture. There are no significant differences in the clinical evolution and prognosis between oral versus short intravenous followed by oral antibiotic. Empirical antibiotic therapy should be guided on local susceptibility patterns. Second-generation cephalosporin (children under six years) and fosfomycin trometamol (over 6 years), are empiric therapy recommended in this consensus. In the case of pyelonephritis, recommended antibiotic treatment are third-generation cephalosporins (outpatient care) or, if admission is required, aminoglycosides. Ampicillin should be added in infants less than three months old. Antibiotic de-escalation both intravenous and oral should be always practiced once the result of the urine culture is known.


REFERENCES

  1. Benítez FR, Jiménez SE. Infección del tracto urinario. Pediatr Integral. 2013; 17: 402-411.

  2. Shaikh N, Hoberman A. Urinary tract infections in infants and children older than one month: Clinical features and diagnosis. UpToDate; 2017 [Consultado 01/08/18]. Available in: http://www.uptodate.com/.

  3. Guía de Práctica Clínica sobre Infección del Tracto Urinario en la Población Pediátrica. Guiasalud 2011 [Consultado 01/08/18]. Disponible en: http://www.guiasalud.es/GPC/GPC_483_ITU_poblacion_pediatrica_ICS_compl.pdf.

  4. González RJ, Rodríguez FL. Infección de vías urinarias en la infancia. Protoc Diagn Ter Pediatr. 2014; 1: 91-108. [Consultado 01/08/18]. Disponible en: https://www.aeped.es/sites/default/files/documentos/07_infeccion_vias_urinarias.pdf.

  5. de Liria CR, Méndez HM, Robles MA. Infección urinaria. Protocolos diagnóstico-terapéuticos de la AEP: Infectología pediátrica. 2012. [Consultado 01/08/18]. Disponible en: https://www.aeped.es/sites/default/files/documentos/itu.pdf.

  6. De la Torre M, De Lucas N, Velasco R, Gómez B, Mintegi S y Grupo para el estudio del lactante febril de la Red de investigación de la Sociedad Española de Urgencias de Pediatría (RISeuP-SPERG). Etiología y evolución de las infecciones potencialmente grave en lactantes menores de 3 meses febriles. An Pediatr (Barc). 2017; 87: 42-49.

  7. Moya-Dionisio V, Díaz-Zabala M, Ibáñez-Fernández A, Suárez-Leiva P, Martínez-Suárez V, Ordóñez-Álvarez FA et al. Patrón de sensibilidad bacteriano y sensibilidad antimicrobiana en urocultivos positivos obtenidos de una población pediátrica. Rev Esp Quimioter. 2016; 29: 146-150.

  8. Nuutinen M, Uhari M. Recurrence and follow-up after urinary tract infection under the age of 1 year. Pediatr Nephrol. 2001; 16: 69-72.

  9. Rodríguez-Lozano J, de Malet A, Cano ME, de la Rubia L, Wallmann R, Martínez-Martínez L. Antimicrobial susceptibility of microorganisms that cause urinary tract infections in pediatric patients. Enferm Infecc Microbiol Clin. 2018; 36: 417-422.

  10. De Lucas CC, Cela AJ, Angulo CA, García AM, Piñeiro PR, Cilleruelo OM, et al. Infecciones del tracto urinario: sensibilidad antimicrobiana y seguimiento clínico. An Pediatr (Barc). 2012; 76: 224-228.

  11. Tena D, González-Praetorius A, González JC, Heredero E, Illescas S, de Baranda CS, et al. Evolución del patrón de sensibilidad de Eschericia coli en infecciones del tracto urinario diagnosticadas en la comunidad durante el periodo 2003-2007. Estudio multicéntrico en Castilla la Mancha. Rev Esp Quimioter. 2010; 23: 36-42.

  12. Molina CJ. Manejo de la infección urinaria en urgencias. An Pediatr Contin. 2011; 9: 7-14.

  13. AAP Subcommittee on Urinary Tract Infection. Reaffirmation of AAP Clinical Practice Guideline: The diagnosis and management of the initial urinary tract infection in febrile infants and young children 2-24 months of age. Pediatrics. 2016; 138: e20163026.

  14. LaRocco MT, Franek J, Leibach EK, Weissfeld AS, Kraft CS, Sautter RL, et al. Effectiveness of preanalytic practices on contamination and diagnostic accuracy of urine cultures: a laboratory medicine best practices systematic review and meta-analysis. Clin Microbiol Rev. 2016; 29: 105-147.

  15. Stein R, Dogan HS, Hoebeke P, Kočvara R, Nijman RJM, Radmayr C, et al. Urinary Tract Infections in Children: EAU/ESPU Guidelines. European Urology. 2015; 67: 546-558.

  16. Ochoa SC, Pascual TA. Revisión sistemática de la validez de los urocultivos recogidos con bolsa estéril perineal. An Pediatr (Barc). 2016; 84: 97-105.

  17. Ochoa SC, Brezmes VM y Grupo Investigador del Proyecto. Métodos para la recogida de muestras de orina para urocultivo y perfil urinario. An Pediatr (Barc). 2007; 67: 442-449.

  18. Doern CD, Richardson SE. Diagnosis of urinary tract infections in children. J Clin Microbiol. 2016; 54: 2233-2242.

  19. Herreros ML, Tagarro A, García-Pose A, Sánchez A, Cañete A, Gili P. Accuracy of a new clean-catch technique for diagnosis of urinary tract infection in infants younger than 90 days of age. Paediatr Child Health. 2015; 20: e30-2.

  20. Yamasaki Y, Uemura O, Nagai T, Yamakawa S, Hibi Y, Yamamoto M et al. Pitfalls of diagnosing urinary tract infection in infants and young children. Pediatr Int. 2017; 59: 786-792.

  21. Velasco R, Benito H, Mozun R, Trujillo JE, Merino PA, de la Torre M et al. Importance of urine dipstick in evaluation of young febrile infants with positive urine culture: a Spanish pediatric emergency research group study. Pediatr Emerg Care. 2016; 32: 851-855.

  22. Tzimenatos L, Mahajan P, Dayan PS, Vitale M, Linakis JG, Blumberg S et al. Accuracy of the urinalysis for urinary tract infections in febrile infants 60 days and younger. Pediatrics. 2018; 141: e20173068.

  23. Primack W, Bukowski T, Sutherland R, Gravens-Mueller L, Carpenter M. What urinary colony count indicates a urinary tract infection in children? J Pediatr. 2017; 191: 259-261.

  24. Swerkersson S, Jodal U, Åhrén C, Sixt R, Stokland E, Hansson S. Urinary tract infection in infants: the significance of low bacterial count. Pediatr Nephrol. 2016; 31: 239-245.

  25. Roberts KB, Wald ER. The diagnosis of UTI: colony count criteria revisited. Pediatrics. 2018; 141: e20173239.

  26. Faura MA, Cuaresma González A, Hernández-Bou S, Trenchs Sainz de la Mazaa V, Camacho Diaz JA, Luaces Cubells C. Rentabilidad diagnóstica de la ecografía renal tras la primera infección de orina en los lactantes. An Pediatr (Barc). 2019; 90 (4): 232-236.

  27. Shaikh N, Ewing AL, Bhatnagar S, Hoberman A. Risk of renal scarring in children with a first urinary tract infection: a systematic review. Pediatrics. 2010; 126: 1084-1091.

  28. Solórzano-Puerto A, Gómez-Luque JM, Luna-del-Castillo JD, Navarro-Marí JM, Gutiérrez-Fernández J. Etiological and resistance profile of bacteria involved in urinary tract infections in young children. Biomed Res Int. 2017; 2017: 4909452.

  29. Hernández R, Guillén E, Bretón-Martínez JR, Giner L, Casado B, Fujkova J et al. Infección urinaria febril adquirida en la comunidad por bacterias productoras de betalactamasas de espectro extendido en niños hospitalizados. Enferm Infecc Microbiol Clin. 2017; 35: 287-292.

  30. García Nieto VM, Luis Yanes MI, Arango Sancho P, Sotoca Fernández JV. Utilidad de las pruebas básicas de estudio de la función renal en la toma de decisiones en niños con pérdida de parénquima renal o dilatación de la vía urinaria. Nefrología. 2016; 36: 222-231.




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