Analysis of the incidence and risk factors of fever-related ureteral stent-associated urinary tract infection in pediatric patients: a retrospective study.

Background: Ureteral stents are commonly used in pediatric urological surgeries but are associated with an increased risk of fever-related ureteral stent-associated urinary tract infection (FUSAUTI). Understanding its incidence and risk factors is essential for improving postoperative care and optimizing management strategies. This study aims to assess the incidence of FUSAUTI in children after urinary tract surgery and explore its associated risk factors.

Methods: A retrospective analysis was conducted on the clinical data of 355 children who underwent ureteral stent placement at Anhui Provincial Children's Hospital from January 2018 to January 2023. Differences in age, gender, type of surgery, previous urinary tract infections (UTIs) and duration of stent placement between the infection and non-infection groups were recorded and compared. Chi-squared tests and t-tests were used to analyze the related factors of FUSAUTI.

Results: Among the 355 children, 32 developed FUSAUTI, resulting in an incidence of 9.01%. Female patients had a higher infection rate than males (34.4% vs. 18.6%, P=0.04). A history of UTI was more common in the infection group (37.5% vs. 20.7%, P=0.03). The infection group had a longer stent duration (52.7±9.6 vs. 48.2±9.7 days, P=0.01). Multivariable analysis identified female gender (OR =2.15, P=0.02), previous UTI (OR =7.31, P=0.004), and longer stent duration (OR =1.05 per day, P=0.01) as independent risk factors. Age, surgery type, and stent laterality were not significant. Escherichia coli and Enterococcus were the main pathogens found in urine and blood cultures, accounting for 40.6% and 31.2% of urine cultures, respectively.

Conclusions: FUSAUTI is a common complication after urinary tract surgery in children, with an incidence of 9.01%. Female gender, previous UTI, and longer stent duration were identified as independent risk factors for FUSAUTI in pediatric patients. Postoperative management should be strengthened for high-risk patients, and monitoring for infections during the stent placement period is essential to reduce the occurrence of FUSAUTI.