Culture-positive urinary tract infection following micturating cystourethrogram in children

Objective:To determine the incidence of culture-positive urinary tract infection(UTI) after micturating cystourethrogram(MCUG).We further wanted to identify risk factors for developing a culture-positive UTI following MCUG.Methods:A retrospective review of the available medical records of 500 paediatric patients who underwent MCUG in Perth,Western Australia was performed.Results:Seven(1.4%) patients comprised of four females and three males developed a febrile,culture-positive UTI within 14 days following MCUG.Significant association was found for female patients,patients with neurogenic bladder,and patients with previous culture-positive UTI as developing a culture-positive UTI following MCUG.Multivariate logistic regression determined that patients were more likely to develop culture-positive UTI within 14 days following MCUG if they had a known history of UTI(odds ratio:5.0,95% confidence interval:1.5-17.3,p=0.010) or had a neurogenic bladder(odds ratio:4.2,95% confidence interval:1.0-17.9,p=0.049).Conclusion:The incidence of patients who developed a febrile,culture-positive UTI following MCUG was low at 1.4%.Statistically significant and independent associations for the development of culture positive UTI were found in patients with neurogenic bladder and patients with previous culture-positive UTI.Further prospective studies are necessary to determine necessity of prophylactic antibiotics for high-risk patients,e.g.,patients with neurogenic bladder or previous culture-positive UTI.