Mp72-07 Variation in Urinary Tract Infection Risk by Race/Ethnicity Among Patients With Vesicoureteral Reflux: A Multicenter Analysis

You have accessJournal of UrologyPediatrics VII (MP72)1 May 2024MP72-07 VARIATION IN URINARY TRACT INFECTION RISK BY RACE/ETHNICITY AMONG PATIENTS WITH VESICOURETERAL REFLUX: A MULTICENTER ANALYSIS Elias J. Wehbi, Carol A. Davis-Dao, Allen Nguyen, Sara Alshehabi, Cameron J. Hinkel, Kai-Wen Chuang, Heidi A. Stephany, Ala'a Farkouh, Ruby Kuang, David A. Chamberlin, Emily S. Blum, Joshua D. Chamberlin, Christopher S. Cooper, Andrew J. Kirsch, and Antoine E. Khoury Elias J. WehbiElias J. Wehbi , Carol A. Davis-DaoCarol A. Davis-Dao , Allen NguyenAllen Nguyen , Sara AlshehabiSara Alshehabi , Cameron J. HinkelCameron J. Hinkel , Kai-Wen ChuangKai-Wen Chuang , Heidi A. StephanyHeidi A. Stephany , Ala'a FarkouhAla'a Farkouh , Ruby KuangRuby Kuang , David A. ChamberlinDavid A. Chamberlin , Emily S. BlumEmily S. Blum , Joshua D. ChamberlinJoshua D. Chamberlin , Christopher S. CooperChristopher S. Cooper , Andrew J. KirschAndrew J. Kirsch , and Antoine E. KhouryAntoine E. Khoury View All Author Informationhttps://doi.org/10.1097/01.JU.0001009572.60675.69.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Changing criteria for the diagnostic workup of children with urinary tract infections (UTI) has impacted the landscape of patients diagnosed with vesicoureteral reflux (VUR). In parallel, the Hispanic population has increased dramatically in the United States. Our objective was to investigate variations in the risk of urinary tract infection by race/ethnicity in a contemporary group of patients with VUR with a focus on Hispanic patients. METHODS: Patients with primary VUR diagnosed by voiding cystourethrogram from 2010-2021 were collected from four academic centers. Children with secondary VUR, ureterocele, multicystic dysplastic kidney, less than 3 months of follow-up or incomplete data were excluded. Primary outcome was urinary tract infection (confirmed by proper collection method, pyuria and single-organism culture) during two years of follow-up following diagnosis defined. Multivariable Cox regression analysis was used to estimate adjusted UTI risk. RESULTS: Of 848 patients, 781 met inclusion criteria. Median age at diagnosis was 7 months (IQR 3.0 - 27.7) and 40% (311/781) were male. Primary indication for initial VCUG was febrile UTI (70%; 549/781). One-third of patients had high grade reflux (grades IV-V) (257/781). Of those patients with self-reported race and ethnicity, 43% (333/781) were Hispanic. UTI rates were found to vary significantly by race/ethnicity. Non-Hispanic white patients had a 13% UTI rate, while Hispanic patients, had a 23% UTI rate. Among the 52 Asian-American patients, the UTI rate was 17%. Only 12 patients in this study were African American and none developed a UTI. In multivariable Cox regression analysis, the effect of race/ethnicity was analyzed with adjustment for significant UTI risk factors: grade of reflux, gender, circumcision status and antibiotic prophylaxis at baseline. In comparison with non-Hispanic White patients, Hispanic patients had a significantly increased risk of UTI while adjusting for other UTI risk factors (HR 1.6, 95% CI 1.03-2.40, p=0.03). CONCLUSIONS: In a large multicenter group of patients with VUR, we found that Hispanic patients had a significantly increased UTI risk compared with non-Hispanic white patients. We also confirm that the rate of UTI among African American patients with VUR is low. The risk of UTI among Hispanic patients is noteworthy, as this is a rapidly expanding population in the U.S. The reasons for this difference in UTI risk and the possible impact of healthcare disparities among this population of patients are of concern and require further investigation. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1174 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Elias J. Wehbi More articles by this author Carol A. Davis-Dao More articles by this author Allen Nguyen More articles by this author Sara Alshehabi More articles by this author Cameron J. Hinkel More articles by this author Kai-Wen Chuang More articles by this author Heidi A. Stephany More articles by this author Ala'a Farkouh More articles by this author Ruby Kuang More articles by this author David A. Chamberlin More articles by this author Emily S. Blum More articles by this author Joshua D. Chamberlin More articles by this author Christopher S. Cooper More articles by this author Andrew J. Kirsch More articles by this author Antoine E. Khoury More articles by this author Expand All Advertisement PDF downloadLoading ...