Does Hirschsprung Disease Increase the Risk of Febrile Urinary Tract Infection in Children

NCT04837963 | Completed

• 1 other identifier: RECHMPL21_0225
• Study Type: observational
• Target: 630
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Hirschsprung Disease; Febrile Urinary Tract Infection (Disorder)

Keywords

Pediatric Surgery; Case Control study

Outcome Measures

Primary Outcomes (1)

• Compare the risk of febril urinary tract infection

  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

Secondary Outcomes (2)

• Compare the age at the time of febrile urinary tract infection

  Day 1

• Febrile urinary tract infection risk factor

  Day 1

Eligibility Criteria

• Age: Up to 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Cases were patients who underwent surgical treatment of an HD confirmed on histopathologic exam. Controls were children who underwent an appendicetomy for acute appendicitis without history of HD, ano rectal malformation or any other colic disease.. Two controls were matched for age and sex, at least included for each case

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• University Hospital, Montpellier: lead

Study Sites (1)

University hospital of Montpellier

Montpellier, 34295, France

Location

MeSH Terms

Conditions

Hirschsprung Disease

Condition Hierarchy (Ancestors)

Digestive System Abnormalities; Digestive System Diseases; Megacolon; Colonic Diseases; Intestinal Diseases; Gastrointestinal Diseases; Congenital Abnormalities; Congenital, Hereditary, and Neonatal Diseases and Abnormalities

Study Officials

• Nicolas KALFA

  University Hospital, Montpellier

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 6, 2021
• First Posted: April 8, 2021
• Study Start: May 16, 2021
• Primary Completion: June 30, 2021
• Study Completion: July 30, 2021
• Last Updated: October 19, 2021

Record last verified: 2021-10

Locations

FR (1)