Does Hirschsprung Disease Increase the Risk of Febrile Urinary Tract Infection in Children
Does Hirschsprung Disease Increase the Risk of Febrile Urinary Tract Infection in Children ? A Case-control Study
Febrile urinary tract infection (FUTIs) are the most common bacterial infections in children under the age of 2 years. They represent 7% of children presenting with fever without a source. In case of recurrent or undertreated FUTIs there is a risk for kidney function with the threat of chronic renal failure [7]. They are more often isolated but some FUTIs may reveal an underlying and facilitating condition. Beside the well-known congenital anomalies of the kidneys and urinary tract such as reflux or obstructions, others risk factors for FUTI are reported. Age less than 1 year, uncircumcised males, poor fluid intake, bladder bowel dysfunction (BBD) including dysfunctional voiding pattern and constipation increase the risk of FUTI. The prevalence of BBD in children with FUTIs is far higher than in the general population. Recommendations emphasize on an efficient treatment of BBD in the first-line management of recurring FUTIs and it has been proven to be efficient (ref).
One of the BBD may include Hirschsprung's Disease (HD). HD is the first congenital malformation of the enteric nervous system with a reported prevalence of 1 in 5000 live birth. It's characterized by an aganglionosis and subsequent dysmotility affect by always the anal canal, most commonly there is a rectosigmoid form (74-80%), and less commonly involves a long segment of colon (12-22%) or a total colonic aganglionosis with ileal involvement upto 50 cm proximal to ileocecal junction (4-13%). The treatment is based on the resection of dysfunctional segment of colon with an anastomosis between the normally innervated bowel to the anus, while preserving normal sphincter function. But significant bowel dysfunction may persist postoperatively. 20% of the children present a fecal incontinence, and 14% a constipation in long-term studies. Bladder dysfunction and associated urological anomalies are also reported in these patients. All of that may facilitate the occurrence of febrile urinary tract infections (FUTI) in patients with HD. Unfortunately, few studies focused on this specific population.
The objective of this study was to find out whether children with HD are more prone to develop FUTIs than controls and which patient with HD are more at risk to develop UTIs.
研究概览
研究类型
注册 (实际的)
联系人和位置
学习地点
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Montpellier、法国、34295
- University Hospital of Montpellier
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion criteria:
Patients :
- surgical treatment of an HD confirmed on histopathologic exam.
Controls :
- appendicetomy for acute appendicitis without history of HD, ano rectal malformation or any other colic disease
Exclusion criteria:
- patients with HD but not yet operated
- patient with a stoma at the time of the study
- patient with chronic intestinal pseudo obstruction without HD
学习计划
研究是如何设计的?
设计细节
- 观测模型:病例对照
- 时间观点:追溯
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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Compare the risk of febril urinary tract infection
大体时间:Day 1
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Compare the risk of febril urinary tract infection between children with Hirschsprung disease and control Febrile urinary tract infection was defined as a positive urine examination with a single bacteria with more than 10.5 cfu/mL and more than 10.4 leukocytes/ml associated with fever above 38.5°C
and C-reactive protein (CRP) above 50 mg/
|
Day 1
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Compare the age at the time of febrile urinary tract infection
大体时间:Day 1
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Compare the age at the time of febrile urinary tract infection between children with Hirschsprung disease and control.
This event could occur sooner in children with Hirschsprung disease than controls.
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Day 1
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Febrile urinary tract infection risk factor
大体时间:Day 1
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Febrile urinary tract infection risk factor for children with Hirschsprung disease based upon the form of the disease, kinf of surgery, functional results For each patient treated by Hirschsprung disease, surgical technique, the level of involvement and the functional outcome will be collected. The functional outcome was evaluated through the number of stool per day, the presence of soiling, the need of additional antegrade or retrograde colonic enema |
Day 1
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合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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