Recurrent Urinary Tract Infections Risk Factors in Patients with Primary Vesicoureteral Reflux

Abstract

Background: Knowing the risk of recurrence of urinary tract infection (UTI) in vesicoureteral reflux (VUR) can assist clinicians to sort therapeutic decisions. The current study's aim was to assess the association of UTI in VUR. Additionally, UTI recurrence might be predicted by the risk score. Materials and Methods: This case-control study was carried out on 123 children at department of Paediatric, Saidu Group of Teaching Hospitals, Swat for the duration of one year from 1st July 2020 to 30thJune 2021. Out of 123 children, the group-I had 57 children with documented previous UTIs history while group-II had 66 children with no previous UTIs and was referred to as a control group. All the patients were VUR diagnosed and were thoroughly followed up at a Renal Unit of single tertiary. UTI recurrence was referred to more than one follow-up episode. A regression model was used for independent variables identification regarding UTI recurrence. . A questionnaire on bowel habits was provided to the parents. The abdominal plain film was evaluated by the observer and recorded on the documented scoring system. The constipation history was compared with the radiological and symptomatic scores. Organism single species with > 105/ml count in a single midstream catch of urine sample was reflected as UTI evidence. Result: Out of 123 children, 88 (71.5%) were females while 35 (28.5%) were male. A total of 123 children had been investigated for UTI complaints. After the multivariable analysis adjustment, five recurrent UTIs predictor variables were the clinical presentation of UTI, female gender, reflux several grades, age less than 6 months, and syndrome dysfunction elimination. The UTIs recurrence risk factors were classified as high, medium, and low with prevalence 52 (42%), 41 (34%), and 30 (24%) respectively. The prevalence of UTIs rate per person-month was 10.9 (95% CI, 9.8, 12.7), 8.2 (95% CI, 6.7, 9.1) for medium, and 5.2 (95% CI, 3.3, 5.5) for the low-risk group. Conclusion: The formulation of therapeutic strategies can be done based on prediction model for UTIs recurrence besides early detection of morbidity long-term risk for the patients. Keywords: Vesicoureteral reflux, Urinary tract infection, Dysfunctional voiding, Constipation