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Management of Febrile Urinary Tract Infection With or Without Bacteraemia in Children: A French Case-Control Retrospective Study

Background: Febrile urinary tract infections (FUTIs) are common among children, and are associated with a bacteraemia between 4 and 7% of cases. No data is available concerning the management of children with a bacteraemic FUTI. Objectives: To compare the antibiotic treatment (parenteral and total d...

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Autores principales: Goeller, Caroline, Desmarest, Marie, Garraffo, Aurélie, Bonacorsi, Stéphane, Gaschignard, Jean
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270401/
https://www.ncbi.nlm.nih.gov/pubmed/32548080
http://dx.doi.org/10.3389/fped.2020.00237
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author Goeller, Caroline
Desmarest, Marie
Garraffo, Aurélie
Bonacorsi, Stéphane
Gaschignard, Jean
author_facet Goeller, Caroline
Desmarest, Marie
Garraffo, Aurélie
Bonacorsi, Stéphane
Gaschignard, Jean
author_sort Goeller, Caroline
collection PubMed
description Background: Febrile urinary tract infections (FUTIs) are common among children, and are associated with a bacteraemia between 4 and 7% of cases. No data is available concerning the management of children with a bacteraemic FUTI. Objectives: To compare the antibiotic treatment (parenteral and total duration) among children with bacteraemic and non-bacteraemic FUTIs, and the mean hospital length of stay (LOS); to describe clinical, microbiological and imaging features of children with bacteraemic and non-bacteraemic FUTIs and observed management modifications when the blood culture was positive. Methods: A retrospective case-control study between 2009 and 2015 at Robert Debré's Pediatric Emergency Department (Paris, France). Children with a bacteraemic FUTI were included and matched for age and sex with two children with a non-bacteraemic FUTI. Results: We included 50 children with a bacteraemic FUTI matched to 100 children with a non-bacterameic FUTI. The mean duration of parenteral antibiotics was longer for bacteraemic children (6.7 vs. 4.0 days, p < 0.001) but this difference was only significant in children > 28 days-old. The mean total duration of antibiotic was similar (11.3 vs. 11.6 days, p = 0.61). The mean LOS was longer for bacteraemic children (5.1 vs. 2.0 days, p < 0.001) but this difference was only significant in children > 28 days-old. A positive blood culture changed the management in 66% of patients. Clinical features at presentation were comparable. Bacteraemic patients had a higher procalcitonin (p = 0.006) and C-reactive protein (p = 0.01), lower mean lymphocyte count (p < 0.001). Conclusions: A bacteraemic FUTI in children induced a longer duration of parenteral antibiotic treatment, a longer hospitalization in children > 28 days-old, and a modification of management for 66% of patients.
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spelling pubmed-72704012020-06-15 Management of Febrile Urinary Tract Infection With or Without Bacteraemia in Children: A French Case-Control Retrospective Study Goeller, Caroline Desmarest, Marie Garraffo, Aurélie Bonacorsi, Stéphane Gaschignard, Jean Front Pediatr Pediatrics Background: Febrile urinary tract infections (FUTIs) are common among children, and are associated with a bacteraemia between 4 and 7% of cases. No data is available concerning the management of children with a bacteraemic FUTI. Objectives: To compare the antibiotic treatment (parenteral and total duration) among children with bacteraemic and non-bacteraemic FUTIs, and the mean hospital length of stay (LOS); to describe clinical, microbiological and imaging features of children with bacteraemic and non-bacteraemic FUTIs and observed management modifications when the blood culture was positive. Methods: A retrospective case-control study between 2009 and 2015 at Robert Debré's Pediatric Emergency Department (Paris, France). Children with a bacteraemic FUTI were included and matched for age and sex with two children with a non-bacteraemic FUTI. Results: We included 50 children with a bacteraemic FUTI matched to 100 children with a non-bacterameic FUTI. The mean duration of parenteral antibiotics was longer for bacteraemic children (6.7 vs. 4.0 days, p < 0.001) but this difference was only significant in children > 28 days-old. The mean total duration of antibiotic was similar (11.3 vs. 11.6 days, p = 0.61). The mean LOS was longer for bacteraemic children (5.1 vs. 2.0 days, p < 0.001) but this difference was only significant in children > 28 days-old. A positive blood culture changed the management in 66% of patients. Clinical features at presentation were comparable. Bacteraemic patients had a higher procalcitonin (p = 0.006) and C-reactive protein (p = 0.01), lower mean lymphocyte count (p < 0.001). Conclusions: A bacteraemic FUTI in children induced a longer duration of parenteral antibiotic treatment, a longer hospitalization in children > 28 days-old, and a modification of management for 66% of patients. Frontiers Media S.A. 2020-05-28 /pmc/articles/PMC7270401/ /pubmed/32548080 http://dx.doi.org/10.3389/fped.2020.00237 Text en Copyright © 2020 Goeller, Desmarest, Garraffo, Bonacorsi and Gaschignard. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Goeller, Caroline
Desmarest, Marie
Garraffo, Aurélie
Bonacorsi, Stéphane
Gaschignard, Jean
Management of Febrile Urinary Tract Infection With or Without Bacteraemia in Children: A French Case-Control Retrospective Study
title Management of Febrile Urinary Tract Infection With or Without Bacteraemia in Children: A French Case-Control Retrospective Study
title_full Management of Febrile Urinary Tract Infection With or Without Bacteraemia in Children: A French Case-Control Retrospective Study
title_fullStr Management of Febrile Urinary Tract Infection With or Without Bacteraemia in Children: A French Case-Control Retrospective Study
title_full_unstemmed Management of Febrile Urinary Tract Infection With or Without Bacteraemia in Children: A French Case-Control Retrospective Study
title_short Management of Febrile Urinary Tract Infection With or Without Bacteraemia in Children: A French Case-Control Retrospective Study
title_sort management of febrile urinary tract infection with or without bacteraemia in children: a french case-control retrospective study
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270401/
https://www.ncbi.nlm.nih.gov/pubmed/32548080
http://dx.doi.org/10.3389/fped.2020.00237
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