Urinary Tract Infection

Urinary Tract Infection
 

• Michielsen WJS, Geurs FJC, Verschraegen GLC, et al [ Univ Hosp, De Pintelaan, Belgium
  A Simple and Efficient Urine Sampling Method for Bacteriological Examination in Elderly Women
  Age Ageing 26: 493-495, 1997
    
  Three alternatives are available for collecting urine to diagnose urinary tract infection, a midstream, catheter, and by suprapubic puncture. The last is regarded as the best. Catheterization is painful, resented and requires time.
     
  This article compares the results of cleaning the vulva and using a sterile container placed in the bed pan of the patient or in the toilet, with suprapubic puncture collections. The subjects had an average age of 81 years. 58 were studied. Infection was discovered in 13 of the suprapubic group and 17 of the other.
     
  Despite the small number, the article points out that an invasive procedure can be avoided.
  

• US Alon, S Ganapathy [ Univ of Missouri, Kansas City]
  Should Renal Ultrasonography Be Done Routinely in Children With First Urinary Tract Infections ?
  Clin Pediatr [Phila] 38: 21-25, 1999
      
  Since the mid 1980s, renal untradonography [RUS] has been performed to detect diseases in the upper tract, particularly obstructive uropathy. Recent studies, however, suggest that RUS detect few significant abnormalities in children with first UTI.
      
  Conclusions – Maternal-fetal US is routinely performed in industrialized countries, and these studies detect a significant number of children with congenital obstructive uropathy prenatally. 
      
  Although RUS is usually not indicated in children with first febrile UTI in communities where prenatal US is routine, imaging studies of the lower urinary tract are recommended in such cases.
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  Acute upper tract imaging in children with a UTI is usually not required if the clinical picture promptly improves, because the ultrasonograms rarely show hydronephrosis of obstruction that would alter initial management. 
     
  This may not be applicable to the neonatal period or when the infections occur in males, who are more likely to have obstruction. 
     
  This study clearly shows that a voiding cystourethrogram is the most important study because 40% of the children had reflux in the presence of normal upper tract imaging.
     
  Ultrasound imaging may not influence acute management, but it can strongly influence long-term management.
  

• S Marild , U Jodal Joteborg Univ, Sweden]
  Incidence rate of First- Time Symptomatic Urinary Tract Infection in Children Under 6 Years of Age
  Acta Paediatr 87: 549-552, 1998
       
  Conclusions – the cumulative incidence rates of UTI were 6.6% in girls and 1.8% in boys in the first 6 years of life. Detection of UTI, especially in infants, may be important to preventing renal insufficiency in young adults.