ArticleBMC pediatrics2025
Predictors of recurrence and renal scarring post-urinary tract infection among young febrile infants.
Article in BMC pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Procalcitonin in predicting acute kidney damage in children with initial febrile urinary tract infection: a retrospective study.Translational pediatrics · 2026Article
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10 authors.
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Abstract
backgroundUrinary tract infections (UTIs) among infants ≤ 3 months old are associated with a high risk of recurrence and renal scarring, yet evidence identifying high-risk infants remains limited. We aimed to identify predictors of UTI recurrence and factors associated with renal scarring in this population.
methodsA retrospective chart review was conducted on febrile infants ≤ 3 months at a tertiary paediatric hospital in Singapore, between January 2018 and June 2023. We defined recurrence as any episode occurring within 1 year of the index UTI and renal scarring based on the Technetium-99 m 2,3-dimercapto-succinic-acid (DMSA) scan. Multivariable logistic regression was performed to predict for UTI recurrence and renal scarring, using covariates selected a priori. We presented the adjusted odds ratio (aOR) with corresponding 95% confidence interval (95%CI).
resultsAmong 401 infants (median age: 49 days [28-70]; 76% male), 49 (12.2%) experienced recurrent UTI. Male sex (aOR = 2.80, 95%CI:1.14-8.46, p = 0.041) and ultrasound kidney, ureter, and bladder (US KUB) abnormalities (aOR = 2.72, 95%CI:1.40-5.27, p < 0.05) independently predicted recurrence. Among 161 infants with DMSA performed, 21 (13.0%) developed renal scarring. Scarring was associated with bacteraemia (OR = 4.38, 1.54-12.05, p < 0.05), elevated procalcitonin ≥ 0.5 ug/L (OR = 16.82, 4.53-109.39, p < 0.001), non-E.coli uropathogen (OR = 6.18, 2.37-17.49, p < 0.001), hydronephrosis (OR = 3.04, 1.17-7.87, p < 0.05), and vesicoureteral reflux (VUR) (OR = 18.70, 4.31-133.32, p < 0.001), particularly high-grade severity ≥ 3 (OR = 25.50, 5.74-185.47, p < 0.001). Additionally, multivariable analysis identified US KUB abnormalities (aOR = 3.00, 1.57-5.73, p < 0.001) as an independent predictor of renal scarring.
conclusionWe reported independent predictors of UTI recurrence and risk factors for renal scarring. These patients should receive more intensive monitoring after their index UTI.
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