Toggle Main Menu Toggle Search

Open Access padlockePrints

Low yield from imaging after non-E. coli urine tract infections in children treated in primary care and emergency department

Lookup NU author(s): Dr Yincent TseORCiD, Dr Stephen Owens, Dr Michal Malina, Dr Richard Peace, Milan Gopal


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Background: Imaging is recommended for selected children following urinary tract infections (UTIs) to look for actionable structural abnormalities. Non-E. coli is considered high risk in many national guidelines, but evidence is mainly drawn from small cohorts from tertiary centres.Objective: To ascertain imaging yield from infants and children <12 years diagnosed with their first confirmed UTI (pure single growth >100 000 cfu per ml) in primary care or an emergency department without admission stratified by bacteria type.Design, setting, patients: Data were collected from an administrative database of a UK citywide direct access UTI service between 2000 and 2021. Imaging policy mandated renal tract ultrasound and Technetium-99m dimercaptosuccinic acid scans in all children, plus micturating cystourethrogram in infants <12 months.Results: 7730 children (79% girls, 16% aged <1 year, 55% 1-4 years) underwent imaging after first UTI diagnosed by primary care (81%) or emergency department without admission (13%). E. coli UTI yielded abnormal kidney imaging in 8.9% (566/6384). Enterococcus and KPP (Klebsiella, Proteus, Pseudomonas) yielded 5.6% (42/749) and 5.0% (24/483) with relative risks 0.63 (95% CI 0.47 to 0.86) and 0.56 (0.38 to 0.83)), respectively. No difference was found when stratified by age banding or imaging modality.Conclusion: In this largest published group of infants and children diagnosed in primary and emergency care not requiring admission, non-E. coli UTI was not associated with a higher yield from renal tract imaging.Keywords: Emergency Care; Infectious Disease Medicine; Microbiology; Nephrology; Primary Health Care.

Publication metadata

Author(s): Tse Y, Pickles C, Owens S, Malina M, Peace R, Gopal M

Publication type: Article

Publication status: Published

Journal: Archives of Disease in Childhood

Year: 2023

Volume: 108

Issue: 6

Pages: 474-480

Print publication date: 18/05/2023

Online publication date: 03/03/2023

Acceptance date: 17/02/2023

ISSN (print): 0003-9888

ISSN (electronic): 1468-2044

Publisher: BMJ Publishing Group


DOI: 10.1136/archdischild-2022-324930

PubMed id: 36868793


Altmetrics provided by Altmetric