Improving medical standards of care to children of an early and preschool age with urinary tract infections at the primary care stage
Keywords:urinary tract infection, children
Timely diagnosis, prognostic value of clinical signs and further treatment of patients of an early age with urinary tract infections (UTI) during outpatient stage are important constituents of an integrated management of patients in childhood. The article deals with new approaches concerning clinical algorithm in diagnosis of urinary tract infections in children. The algorithm of diagnostic and therapeutic measures for providing care to children under 5 years of age with urinary tract infections, in particular at the stage of primary care, includes: diagnosis of urinary tract infection in young children using The Diagnosis of Urinary Tract infection in Young children, patient’s examination by Gorelick Scale and UTIcalc, imaging methods with mandatory ultrasound of the kidneys and bladder, micturating cystogram after the first episode of infection in boys and the second — in girls, the prescription of antibiotic therapy based on data from regional monitoring of antibiotic resistance of the main groups of uropathogens, monitoring antibiotic resistance using electronic means and the implementation in microbiological laboratories of the guidelines of the European Committee on Antimicrobial Susceptibility Testing, as well as introduction of the prescription sale of antibiotics.
Korbel L, Howell M, Spencer JD. The clinical diagnosis and management of urinary tract infections in children and adolescents. Paediatr Int Child Health. 2017 Nov;37(4):273-279. doi:10.1080/20469047.2017.1382046.
Diachuk MD, Gruzieva TS. Population morbidity monitoring as a basis for the development of treatment and preventive measures. One Health and Nutrition Problems of Ukraine. 2019;(50):67-74. doi:10.33273/2663-9726-2019-50-1-67-74. (in Ukrainian).
Bezruk VV. Medyko-social'ne obg'runtuvannja optymizovanoi' modeli nadannja specializovanoi' nefrologichnoi' dopomogy ditjam z infekcijno-zapal'nymy zahvorjuvannjamy sechovydil'n oi' systemy na regional'nomu rivni. Diss. dokt. med. nauk [Medical and social substantiation of an optimized model for the provision of specialized nephrological care to children with infectious and inflammatory diseases of the urinary system at the regional level. Dr. med. sci. diss.]. Kyiv; 2021. 44 p. (in Ukrainian).
Robinson JL, Finlay JC, Lang ME, Bortolussi R; Canadian Paediatric Society, Infectious Diseases and Immunization Committee, Community Paediatrics Committee. Urinary tract infections in infants and children: Diagnosis and management. Paediatr Child Health. 2014 Jun;19(6):315-325. doi:10.1093/pch/19.6.315.
Voronenko JuV, Shekera OG, Ivanov DD, editors. Aktual'ni pytannja nefrologii' v praktyci simejnogo likarja: navchal'nyj posibnyk [Current issues of nephrology in the practice of family medicine: a textbook]. Kyiv: Publisher Zaslavsky OYu; 2015. (in Ukrainian).
Budnik TV, Mordovets YeM. The results of the study of microbiologic pattern of the urinary tract infection in children from Kyiv and Kyiv region. Počki. 2016;(16):21-25. doi:10.22141/2307-12188.8.131.526.72744. (in Ukrainian).
Velasco R, Benito H, Mozun R, et al. Using a urine dipstick to identify a positive urine culture in young febrile infants is as effective as in older patients. Acta Paediatr. 2015 Jan;104(1):e39-44. doi:10.1111/apa.12789.
Butler CC, O'Brien K, Pickles T, et al. Childhood urinary tract infection in primary care: a prospective observational study of prevalence, diagnosis, treatment, and recovery. Br J Gen Pract. 2015 Apr;65(633):e217-23. doi:10.3399/bjgp15X684361.
Verbakel JY, Lemiengre MB, De Burghgraeve T, et al. Should all acutely ill children in primary care be tested with point-of-care CRP: a cluster randomised trial. BMC Med. 2016 Oct 6;14(1):131. doi:10.1186/s12916-016-0679-2.
Díaz MG, García RP, Gamero DB, et al. Lack of Accuracy of Biomarkers and Physical Examination to Detect Bacterial Infection in Febrile Infants. Pediatr Emerg Care. 2016 Oct;32(10):664-668. doi:10.1097/PEC.0000000000000401.
Hay AD, Birnie K, Busby J, et al. The Diagnosis of Urinary Tract infection in Young children (DUTY): a diagnostic prospective observational study to derive and validate a clinical algorithm for the diagnosis of urinary tract infection in children presenting to primary care with an acute illness. Health Technol Assess. 2016 Jul;20(51):1-294. doi:10.3310/hta20510.
Duong HP, Wissing KM, Tram N, Mascart G, Lepage P, Ismaili K. Accuracy of Automated Flow Cytometry-Based Leukocyte Counts To Rule Out Urinary Tract Infection in Febrile Children: a Prospective Cross-Sectional Study. J Clin Microbiol. 2016 Dec;54(12):2975-2981. doi:10.1128/JCM.01382-16.
Chaudhari PP, Monuteaux MC, Shah P, Bachur RG. The Importance of Urine Concentration on the Diagnostic Performance of the Urinalysis for Pediatric Urinary Tract Infection. Ann Emerg Med. 2017 Jul;70(1):63-71.e8. doi:10.1016/j.annemergmed.2016.11.042.
Felt JR, Yurkovich C, Garshott DM, et al. The utility of real-time quantitative polymerase chain reaction genotype detection in the diagnosis of urinary tract infections in children. Clin Pediatr (Phila). 2017 Sep;56(10):912-919. doi:10.1177/0009922817706144.
Shaikh N, Hoberman A, Hum SW, et al. Development and validation of a calculator for estimating the probability of urinary tract infection in young febrile children. JAMA Pediatr. 2018 Jun 1;172(6):550-556. doi:10.1001/jamapediatrics.2018.0217.
Chaudhari PP, Monuteaux MC, Bachur RG. Microscopic Bacteriuria Detected by Automated Urinalysis for the Diagnosis of Urinary Tract Infection. J Pediatr. 2018 Nov;202:238-244.e1. doi:10.1016/j.jpeds.2018.07.007.
Mitiku E, Amsalu A, Tadesse BT. Pediatric Urinary Tract Infection as a Cause of Outpatient Clinic Visits in Southern Ethiopia: A Cross Sectional Study. Ethiop J Health Sci. 2018 Mar;28(2):187-196. doi:10.4314/ejhs.v28i2.10.
Tzimenatos L, Mahajan P, Dayan PS, et al. Accuracy of the Urinalysis for Urinary Tract Infections in Febrile Infants 60 Days and Younger. Pediatrics. 2018 Feb;141(2):e20173068. doi:10.1542/peds.2017-3068.
Boon HA, Van den Bruel A, Struyf T, Gillemot A, Bullens D, Verbakel JY. Clinical features for the diagnosis of pediatric urinary tract infections: systematic review and meta-analysis. Ann Fam Med. 2021 Sep-Oct;19(5):437-446. doi:10.1370/afm.2684.
How to Cite
Copyright (c) 2021 V.V. Bezruk, D.D. Ivanov
This work is licensed under a Creative Commons Attribution 4.0 International License.