Resumen

DIAZ ALVAREZ, Manuel et al. Risk of reinfection after the first infection of the urinary tract in the neonatal period. Rev Cubana Pediatr [online]. 2013, vol.85, n.4, pp.486-496. ISSN 0034-7531.

Introduction: there is not enough proof of either the frequency of re-infections after the first infection of the urinary tract in the neonatal period, or the factors associated to them. Objective: to determine the frequency and the factors associated to occurrence of re-infections in patients who suffered the first infection of the urinay tract in the neonatal period. Methods: a longitudinal, observational and analytic study of 399 newborns with first infection of the urinary tract was conducted from 1992 to 2009. These patients had been performed renal ultrasound and mictional cystourethrography and they were followed-up in the outpatient service. Frequency, clinical and demographic factors and imaging assessment associated to the occurrence of re-infections were analyzed. Results: three hundred and ninety nine patients, who showed a follow-up median of 18 months (interquartile interval of 9 to 30 months), were studied. The first re-infection was seen in 48 patients (77.4 %) in the first six months of life whereas 93.5 % of these events occurred within the 12 months of age of the infant. It was evinced that the occurrence of another infection of the urinary tract was five times more likely in patients with vesicoureteral flux and other anomalies in this tract than in those patients who do not have it (OR= 5.11; CI 95 %: 2.66-9.80 and OR= 2.90; IC 95 %: 1.03-8.11, respectively). The percentage of patients who got re-infected increases with the grade of vesicoureteral reflux; it is three times more likely to occur re-infection in patients with severe vesicoureteral reflux grades (IV-V) than in those with lower grade reflux (OR= 9.0; CI 95 %: 3.108-26.057). The statistical linear tendency analysis confirmed that the vesicoureteral reflux grade was significantly related to the occurrence of re-infection (p< 0.01). Conclusions: vesicoureteral reflux and other urinary tract anomalies are risk factors for the urinary tract re-infection; it is more common in patients with higher reflux grade, which predominantly takes place in the first six months after being cured of the first infection in the neonatal period, and over 90% of cases suffered re-infection within the 12 months of age.

Palabras clave : newborn; urinary tract infection; recurrence; vesicoureteral reflux; risk factors.

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