Imaging of Children with a Urinary Tract Infection in North East England

Objective: To assess the outcome of children with a UTI who were investigated according to a guideline specific to the north east of England. The regional paediatric UTI guideline is more rigorous than the NICE guideline CG54 in relation to imaging investigations.

Design: Retrospective clinical audit.

Setting: Specialist emergency care hospital in Northumberland.

Patients: Children between 0 and 15 years.

Results: Ninety urinary tract infections occurred in 83 children during an 8-month-period. The commonest organism was E. coli (83%). Fifty-four percent of E. coli were resistant to at least one antibiotic. Forty-one percent of children received antibiotic prophylaxis after completion of treatment. Seventy-one children (86%) had a renal and bladder ultrasound scan, 43 children had a kidney DMSA scan and 28 had an MCUG.

Conclusion: According to the regional UTI protocol, the 83 children should have had 176 scans (USS, DMSA, MCUG) but they only had 142 scans (81%). Twenty-one scans (15%) showed an abnormality of the renal tract. These real-world data emphasize the importance of imaging investigations in children with a UTI and the need for a user-friendly guideline.