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.

Birth experience of fathers in the setting of teenage pregnancy:Are they prepared?

AIM To explore the birth experiences of teenage fathers and determine the extent to which they are prepared for childbirth.METHODS A mixed methods observational study was undertaken comparing the birth experience of 50 fathers in the setting of teenage pregnancy(teenage) compared to a group of 50 older fathers. Fathers were recruited in the antenatal period and completed structured questionnaires following the birth of their child. Quantitative and qualitative analysis was undertaken.RESULTS Teenage fathers were younger, less educated and less likely to attend prenatal childbirth education classes(P < 0.0001). During birth, they were less prepared and consulted by attending staff(both P < 0.05). They reported limited roles in intrapartum decision-making(< 20%). In multivariate analysis being a father in the setting of teenage pregnancy remained significantly associated with feeling unprepared for birth. The major themes in qualitative analysis were feeling unprepared,shock, fear, a sense of detachment, happiness, pride, love of the baby and satisfaction with fertility.CONCLUSION Teenage fathers are less prepared for the birth of their child and this results in shock, fear and detachment that may impact on the early father-infant relationship.