Update and summary of the EAU/ESPU paediatric guidelines on urinary tract infection in children.

IF 2 3区 医学 Q2 PEDIATRICS
Michele Gnech, Anna Bujons, Christian Radmayr, Lisette 't Hoen, Guy Bogaert, Berk Burgu, Yazan F Rawashdeh, Mesrur Selcuk Silay, Fardod O'Kelly, Josine Quaedackers, Niklas Pakkasjärvi, Allon van Uitert, Martin Skott, Uchenna Kennedy, Yuhong Yuan, Alexandra Zachou, Marco Castagnetti
{"title":"Update and summary of the EAU/ESPU paediatric guidelines on urinary tract infection in children.","authors":"Michele Gnech, Anna Bujons, Christian Radmayr, Lisette 't Hoen, Guy Bogaert, Berk Burgu, Yazan F Rawashdeh, Mesrur Selcuk Silay, Fardod O'Kelly, Josine Quaedackers, Niklas Pakkasjärvi, Allon van Uitert, Martin Skott, Uchenna Kennedy, Yuhong Yuan, Alexandra Zachou, Marco Castagnetti","doi":"10.1016/j.jpurol.2025.06.016","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objective: </strong>These guidelines aim to provide a practical approach for both diagnosis and management of urinary tract infections (UTI).</p><p><strong>Objective: </strong>To highlight 2025 update of the Guidelines of the European Association of Urology (EAU) and the European Society for Paediatric Urology (ESPU) on UTI in children.</p><p><strong>Methods: </strong>A structured literature review was performed for all relevant litterature from the last update (2021) up to 20th February 2024.</p><p><strong>Key findings and limitations: </strong>UTIs represent the most common bacterial infections in children. The leading causative organism is Escherichia Coli (E. Coli), however, other bacteria have been increasing in prevalence, as has the prevalence of multi-resistent E. Coli infections. UTIs can be classified in several ways including upper vs. lower urinary tract UTIs; febrile vs. non febrile UTIs; first vs. recurrent vs. breakthrough episode; typical vs. atypical. Urine samples for analysis can be collected by urine bag, clean catch, catheterization, or suprapubic aspiration. Methods for urinalysis include dipstick, microscopy and flow imaging analysis technology. Each collection and analysis method has its own advanatages and drawbacks. Microscopic urinalysis is recommended after a positive dipstick test. In terms of additional investigations, the Panel generally recommends a renal and bladder ultrasound after an initial febrile UTI, whereas additional investigations should be considered based on the characteristics of the patient and of the infection. A flow-chart is proposed. The cornerstone of UTI management is prompt antimicrobial therapy. The administration route should be chosen based on several variables. The agent should be chosen based on local antimicrobial sensitivity patterns, and adjusted according to sensitivity-testing. Interventions can be considered to prevent UTI recurrence including chemoprophylaxis, non-antibiotic prophylaxis, and treatment of phimosis, bladder-bowel dysfunction and lower urinary tract dysfunction.</p><p><strong>Conclusions and clinical implications: </strong>This paper is a summary of the 2025 updated (Table) of EAU/ESPU Guidelines and provides practical considerations for the management and diagnostic evaluation of UTI in children.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric Urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jpurol.2025.06.016","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0

Abstract

Background and objective: These guidelines aim to provide a practical approach for both diagnosis and management of urinary tract infections (UTI).

Objective: To highlight 2025 update of the Guidelines of the European Association of Urology (EAU) and the European Society for Paediatric Urology (ESPU) on UTI in children.

Methods: A structured literature review was performed for all relevant litterature from the last update (2021) up to 20th February 2024.

Key findings and limitations: UTIs represent the most common bacterial infections in children. The leading causative organism is Escherichia Coli (E. Coli), however, other bacteria have been increasing in prevalence, as has the prevalence of multi-resistent E. Coli infections. UTIs can be classified in several ways including upper vs. lower urinary tract UTIs; febrile vs. non febrile UTIs; first vs. recurrent vs. breakthrough episode; typical vs. atypical. Urine samples for analysis can be collected by urine bag, clean catch, catheterization, or suprapubic aspiration. Methods for urinalysis include dipstick, microscopy and flow imaging analysis technology. Each collection and analysis method has its own advanatages and drawbacks. Microscopic urinalysis is recommended after a positive dipstick test. In terms of additional investigations, the Panel generally recommends a renal and bladder ultrasound after an initial febrile UTI, whereas additional investigations should be considered based on the characteristics of the patient and of the infection. A flow-chart is proposed. The cornerstone of UTI management is prompt antimicrobial therapy. The administration route should be chosen based on several variables. The agent should be chosen based on local antimicrobial sensitivity patterns, and adjusted according to sensitivity-testing. Interventions can be considered to prevent UTI recurrence including chemoprophylaxis, non-antibiotic prophylaxis, and treatment of phimosis, bladder-bowel dysfunction and lower urinary tract dysfunction.

Conclusions and clinical implications: This paper is a summary of the 2025 updated (Table) of EAU/ESPU Guidelines and provides practical considerations for the management and diagnostic evaluation of UTI in children.

EAU/ESPU关于儿童尿路感染的儿科指南的更新和总结。
背景和目的:本指南旨在为尿路感染(UTI)的诊断和治疗提供实用的方法。目的:强调2025年欧洲泌尿外科协会(EAU)和欧洲儿科泌尿外科学会(ESPU)关于儿童尿路感染的指南更新。方法:对上次更新(2021年)至2024年2月20日的所有相关文献进行结构化文献综述。主要发现和局限性:尿路感染是儿童中最常见的细菌感染。主要的致病生物是大肠杆菌(E. Coli),然而,其他细菌的流行率也在增加,正如多重耐药大肠杆菌感染的流行率一样。尿路感染可分为上尿路感染和下尿路感染;发热性与非发热性尿路感染;首发vs复发vs突破发作;典型vs非典型。用于分析的尿样可通过尿袋、清洁收集器、导尿或耻骨上抽吸收集。尿液分析方法包括试纸、显微镜和血流成像分析技术。每种收集和分析方法都有其自身的优点和缺点。在试纸试验呈阳性后,建议进行尿镜分析。在附加检查方面,专家组一般建议在出现发热性尿路感染后进行肾脏和膀胱超声检查,而应根据患者和感染的特点考虑附加检查。提出了一个流程图。尿路感染管理的基石是及时的抗菌治疗。应该根据几个变量来选择管理路由。应根据当地的抗菌药物敏感性模式选择药物,并根据敏感性测试进行调整。预防尿路感染复发的干预措施包括化学预防、非抗生素预防、包茎、膀胱-肠功能障碍和下尿路功能障碍的治疗。结论及临床意义:本文总结了2025年更新的EAU/ESPU指南(表),为儿童尿路感染的管理和诊断评估提供了实际考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Pediatric Urology
Journal of Pediatric Urology PEDIATRICS-UROLOGY & NEPHROLOGY
CiteScore
3.70
自引率
15.00%
发文量
330
审稿时长
4-8 weeks
期刊介绍: The Journal of Pediatric Urology publishes submitted research and clinical articles relating to Pediatric Urology which have been accepted after adequate peer review. It publishes regular articles that have been submitted after invitation, that cover the curriculum of Pediatric Urology, and enable trainee surgeons to attain theoretical competence of the sub-specialty. It publishes regular reviews of pediatric urological articles appearing in other journals. It publishes invited review articles by recognised experts on modern or controversial aspects of the sub-specialty. It enables any affiliated society to advertise society events or information in the journal without charge and will publish abstracts of papers to be read at society meetings.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信