Pediatric UTI Risk Post-Cystography: Insights from Ultrasound Studies

In a study investigating post-cystography urinary tract infections (PCUTI) in a contemporary pediatric population, researchers reviewed the records of 1,656 patients who underwent voiding cystourethrogram (VCUG), radionuclide cystogram (RNC), or contrast-enhanced voiding urosonography (CEUS) from February 1, 2021, to August 15, 2022. After excluding 681 patients without accessible primary provider records and 60 patients with significant urinary tract infections at the time of cystography, a total of 913 patients were analyzed. The median age of these patients was 1.42 years. The study found that 1.9% of patients met the strict definition for PCUTI, while 3.6% met a pragmatic definition that included those with a high clinical suspicion for infection. Notably, patients who developed PCUTI were significantly more likely to have parenchymal abnormalities on pre-cystography ultrasound (41.4% compared to 22.4%, p=0.017) and to have vesicoureteral reflux (VUR) without continuous antibiotic prophylaxis at the time of the cystography (33.3% versus 19.1%, p=0.035). These findings highlight the relatively low incidence of PCUTI following cystography procedures and underscore the importance of identifying specific risk factors, such as pre-existing parenchymal abnormalities and VUR, to improve counseling and management strategies for pediatric patients undergoing these diagnostic imaging studies. By focusing on these risk factors, healthcare providers can enhance patient safety and optimize follow-up care following cystography.