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URINARY TRACT INFECTIONS IN CHILDREN WITH PRENATAL
HYDRONEPHROSIS: AN ASSESSMENT FROM THE SOCIETY FOR FETAL UROLOGY
HYDRONEPHROSIS REGISTRY
Rebecca ZEE
1
, Anthony HERNDON
1
, Christina KIM
2
, Jessica JACKSON
1
, Patrick MCKENNA
3
and Katherine HERBST
2
1) University of Virginia School of Medicine, Urology, Charlottesville, USA - 2) University of Connecticut School of
Medicine, Urology, Hartford, USA - 3) University of Wisconsin School of Medicine and Public Health, Urology, Madison,
USA
PURPOSE
Risk factors for urinary tract infections (UTI) in children with prenatal hydronephrosis (PNH) have yet to be clearly
defined. The study aim was to describe the incidence and identify factors associated with UTI amongst a cohort of
children diagnosed with PNH.
MATERIAL AND METHODS
Patients with confirmed PNH from three medical centers were prospectively enrolled in the Society for Fetal Urology
(SFU) hydronephrosis registry 10/2008-3/2015. Exclusion criteria included enrollment due to UTI or less than 1 month
of follow-up. Univariate analysis was performed using Fisher’s Exact Test or Mann-Whitney U. Probability for UTI was
determined by Kaplan-Meier curve.
RESULTS
Median follow up was 10 months (1-60) in 168 patients (n=120 male). UTI developed in 9.5% (n=16) of patients. Of
these, 46% were febrile, and 46% were breakthrough. Probability of UTI in the first year of life was 11.5%. UTI
occurred more frequently in females (p<.001), uncircumcised males (p=0.054), and subjects with high grade (3-4)
hydronephrosis (HGH) versus low grade hydronephrosis (LGH) (p<0.05). Renal cysts were also associated with UTI
(p<0.05). Use of prophylactic antibiotics (PA), presence of vesicoureteral reflux (VUR), dilated ureter, and renal
duplication were not significantly associated with UTI.
Characteristic
UTI Yes
UTI No
p-value
Patients
16(10%) 152(90%)
Follow-up (months)
11.5(2-49) 10(1-60) 0.574
Gender
Male
3(2%)
117(98%)
Female
13(27%) 35(73%) <0.001
Uncircumcised
2(8%)
22(92%) 0.054
SFU Grade
High (SFU 3-4)
9(16%)
46(84%) <0.05
Low (SFU 0-2)
7(6%)
104(94%)
VUR
5(23%)
17(77%) 0.125
Prophylactic Antibiotics 13(12%) 94(88%) 0.100
Renal Cyst
2(40%)
3(60%)
<0.05
CONCLUSIONS
Significantly associated characteristics for UTI in patients with PNH included female gender, HGH, and renal cysts.
Uncircumcised status approached significance. Use of PA, VUR status, presence of dilated ureter, and duplication status
did not impact UTI in this population.