Management of Pediatric Urinary Tract Infections in Kuwait: Current Practices and Practicality of New Guidelines

Objective: To evaluate the practicality of applying the new international guidelines for urinary tract infection (UTI) management in children hospitalized with their first UTI in a tertiary care hospital in Kuwait Design: Retrospective study Setting: Pediatric wards at the Mubarak Al Kabeer Hospital; period of study: from June 2011 - May 2012 Subjects: Children up to 12 years of age with pyuria and at least 50,000 colonies per ml of a single uropathologic organism in an appropriately collected urine sample Intervention: None Main Outcome Measures: Incidence of vesico-ureteric reflux (VUR) in children with first UTI and normel renal ultrasound (RUS) Results: One hundred and forty nine children were included. 53% were male. Recurrent UTI was present in 15% of cases. The most commonly isolated bacteria were: E. coli (69%), Klebsiella pneumoniae (11.4%) and Pseudomonas aeruginosa (5.4%). VUR was found in 7.5% children with first UTI and normal RUS and in 50% of children with abnormal RUS. In children with recurrent UTI, 23 % had VUR. Renal scarring was found in five children. Conclusions: The finding of low VUR rate in children with first UTI and normel RUS makes changing the current practice for the diagnosis and management of UTI to recent guidelines safe and valuable.