Takuma Ohnishi1, Yoshinori Mishima2, Nozomi Matsuda3, Daisuke Sato4, Daisuke Umino5, Ryuta Yonezawa6, Keiji Kinoshita7, Kikuko Tamura8, Shigenao Mimura9, Shohei Ariji10, Naonori Maeda11, Keiko Ozaki12, Hiroyuki Fukushima13, Tomohiro Arakuma14, Satoko Tsuchida15, Hajime Nishimoto16, Yoshinori Araki17, Makoto Yoshida18, Takuya Tamame19, Shigeru Suzuki20, Toshio Sekijima21, Takanori Kowase22, Kanae Takahashi23, Isamu Kamimaki2. 1. Department of Pediatrics, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako-shi, Saitama 351-0102, Japan; Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. Electronic address: prince1999and7@a2.keio.jp. 2. Department of Pediatrics, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako-shi, Saitama 351-0102, Japan. 3. Department of Pediatrics, Soka Municipal Hospital, 2-21-1 Soka, Soka-shi, Saitama 340-8560, Japan. 4. Department of Pediatrics, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi-shi, Saitama 332-8558, Japan. 5. Tsuchiya Children's Hospital, 3-1-10 Kukichuou, Kuki-shi, Saitama 346-0003, Japan. 6. Department of Pediatrics, IMS Fujimi General Hospital, 1967-1 Tsuruma, Fujimi-shi, Saitama 354-0021, Japan. 7. Department of Pediatrics, Koshigaya Municipal Hospital, 10-47-1 Higashikoshigaya, Koshigaya-shi, Saitama 343-8577, Japan. 8. Department of Pediatrics, National Hospital Organization Nishisaitama-chuo National Hospital, 2-1671 Wakasa, Tokorozawa-shi, Saitama 359-1151, Japan. 9. Department of Pediatrics, Ageo Central General Hospital, 1-10-10 Komaza, Ageo-shi, Saitama 362-8588, Japan. 10. Department of Pediatrics, Kawaguchi Municipal Medical Center, 180 Araijuku, Kawaguchi-shi, Saitama 333-0833, Japan. 11. Department of Pediatrics, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan. 12. Department of Pediatrics, Hino Municipal Hospital, 4-3-1 Tamadaira, Hino-shi, Tokyo 191-0062, Japan. 13. Department of Pediatrics, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa-shi, Chiba 272-8513, Japan. 14. Department of Pediatrics, Saitama Cooperative Hospital, 1317 Kisoro, Kawaguchi-shi, Saitama 333-0831, Japan. 15. Department of Pediatrics, Japanese Red Cross Akita Hospital, 222-1 Kamikitatesarutanawashirosawa, Akita-shi, Akita 010-1495, Japan. 16. Department of Pediatrics, Saitama Citizens Medical Center, 299-1 Shimane, Nishi-ku, Saitama-shi, Saitama 331-0054, Japan. 17. Department of Pediatric Nephrology, National Hospital Organization Hokkaido Medical Center, 5-7-1-1 Yamanote, Nishi-ku, Sapporo-shi, Hokkaido 063-0005, Japan. 18. Department of Pediatrics, Sano Kosei General Hospital, 1728 Horigome-cho, Sano-shi, Tochigi 327-8511, Japan. 19. Department of Pediatrics, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama-shi, Saitama 336-8522, Japan. 20. Department of Pediatrics, Seirei Sakura Citizen Hospital, 2-36-2 Eharadai, Sakura-shi, Chiba 285-0825, Japan. 21. Department of Pediatrics, Hanyu General Hospital, 446 Shimoiwase, Hanyu-shi, Saitama 348-8505, Japan. 22. Department of Pediatrics, Gyoda General Hospital, 376 Mochida, Gyoda-shi, Saitama 361-0056, Japan. 23. Department of Medical Statistics, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku, Osaka-shi, Osaka 545-8585, Japan.
Abstract
BACKGROUND: Febrile urinary tract infection (fUTI) is the most common serious bacterial infection in children. Despite this, there have been no studies examining the clinical features of pediatric fUTI in Japan. The purpose of this study was to describe the clinical characteristics of fUTI in Japanese children. METHODS: A multicenter, retrospective, observational study was conducted at 21 hospitals in Japan. Children under the age of 15 years who were diagnosed with fUTI between 2008 and 2017 were included. The diagnostic criteria were a temperature over 38 °C and the presence of a single bacterial pathogen in urine culture. Patient characteristics were obtained from medical records. RESULTS: In total, 2,049 children were included in the study. The median age was 5 months, and 59.3% were male. It was found that 87.0% of the males and 53.2% of the females were under 1 year of age. The main causative pathogens identified were Escherichia coli and Enterococcus spp., accounting for 76.6% and 9.8% of infections, respectively. CONCLUSIONS: There was a male predominance of fUTI in Japanese children, particularly in infants. Enterococcus spp. were the second most frequent causative pathogen; therefore, Gram staining of urine samples is strongly recommended before initiating antibiotic therapy.
BACKGROUND:Febrile urinary tract infection (fUTI) is the most common serious bacterial infection in children. Despite this, there have been no studies examining the clinical features of pediatric fUTI in Japan. The purpose of this study was to describe the clinical characteristics of fUTI in Japanese children. METHODS: A multicenter, retrospective, observational study was conducted at 21 hospitals in Japan. Children under the age of 15 years who were diagnosed with fUTI between 2008 and 2017 were included. The diagnostic criteria were a temperature over 38 °C and the presence of a single bacterial pathogen in urine culture. Patient characteristics were obtained from medical records. RESULTS: In total, 2,049 children were included in the study. The median age was 5 months, and 59.3% were male. It was found that 87.0% of the males and 53.2% of the females were under 1 year of age. The main causative pathogens identified were Escherichia coli and Enterococcus spp., accounting for 76.6% and 9.8% of infections, respectively. CONCLUSIONS: There was a male predominance of fUTI in Japanese children, particularly in infants. Enterococcus spp. were the second most frequent causative pathogen; therefore, Gram staining of urine samples is strongly recommended before initiating antibiotic therapy.