Unit:
Κατεύθυνση Κλινική Παιδιατρική & Νοσηλευτική - ΈρευναLibrary of the School of Health Sciences
Author:
Kartsiouni Elpiniki
Supervisors info:
Σιαχανίδου Σουλτάνα, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Χαρμανδάρη Ευαγγελία, Καθηγήτρια, Ιατρική, ΕΚΠΑ
Μίχος Αθανάσιος, Αναπληρωτής Καθηγητής, Ιατρική ΕΚΠΑ
Original Title:
Απεικονιστικός έλεγχος ουροποιητικού σε νεογνά με ουρολοίμωξη
Translated title:
Role of renal ultrasonography in predicting vesicoureteral reflux and role of DMSA renal scan in neonates with the first UTI
Summary:
BACKGROUND AND OBJECTIVE: Urinary tract infection (UTI) represents a common bacterial infection in neonates, and its prevalence increases with the presence of high- grade vesicoureteral reflux (VUR). However, voiding cystourethrography (VCUG) is invasive, and its indication in neonates is not yet defined. This study aims to investigate, in neonates aged 0-28 days, if normal or abnormal ultrasound (US) or the presence of Escherichia coli versus non- E. coli bacteria could avoid the use of VCUG. Furthermore, the aim of this study was to correlate the findings of VCUG with abnormal findings in dimercaptosuccinic acid (DMSA) renal scan 6 months after the first UTI.
METHOD: Two hundred and nineteen neonates with a first UTI were enrolled. High- grade VUR was defined by the presence of VUR grade ≥III. The presence of high- grade VUR was recorded using VCUG, and correlated with the presence of normal/ abnormal renal US and with the presence of E. coli/ non- E. coli UTI. Moreover, the findings of VCUG were correlated with abnormal findings in DMSA renal scan 6 months after the first UTI.
RESULTS: 48% of neonates with high- grade VUR had normal findings in renal US. Moreover, E. coli was isolated in urine culture in 69, 3% of neonates with UTI with abnormal findings in VCUG . Furthermore, 22/79 neonates with normal VCUG had abnormal findings in DMSA renal scan.
CONCLUSIONS: In neonates aged 0-28 days with a first UTI, the presence of normal renal US findings or the presence of E. coli in urine culture do not allow to safely avoid VCUG. Furthermore, a number of neonates with normal findings in VCUG may have abnormal findings in DMSA renal scan.
Main subject category:
Health Sciences
Keywords:
Urinary tract infections in neonates, VCUG in neonates, DMSA in neonates, Ultrasound after the first UTI