Current guidelines advise the prompt diagnosis and treatment of urinary tract infection (UTI) in children to improve both short and longer term outcomes. However, the risk of long-term complications following childhood UTI is unclear. UTI is relatively common but difficult to diagnose in children as symptoms are non-specific. Diagnosis requires a urine sample; so but sampling is difficult and infrequent; also it is not clear if sampling should be given greater priority in primary care.
The LUCI study will assess the short, medium and longer term outcomes of childhood UTI associate with routine and systematic sampling practices. In this study they will describe clinical outcomes for all children with one or more mcUTIs age less than 5 years old, compare with those with no mcUTI; so using National Health Service (NHS) laboratory data from across Wales. They will examine the risk factors for being diagnose with renal scarring following mcUTI.
Anonymised data set made available
The governance surrounding data set 1 differs from data set 2. Data set 1 is an anonymised data set made available from SAIL Data bank with only approval require from the IGRP whereas data set 2 involves the transfer of identifiable data to data providers which requires ethical approval; so s251 support, IGRP and IGARD approval. In order to obtain an unbiased sample from the DUTY and EURICA cohorts, an opt-out consent model is be use.
The LUCI study will report the risk of renal scarring for children; so with and without childhood mcUTI across the whole of Wales. The linking of routinely collect data sets will give us a large cohort including demographic; so hospital inpatient and outpatient, GP and microbiology data; allowing us to define mcUTI cases and describe outcomes for all children from both primary and secondary care.
Clarifying the link between UTI, renal scarring and long-term complications will inform; so the management of acutely ill children in primary care, where the need for urine sampling is unclear. Determining the clinical implications of ‘missed’ cases of UTI through our comparison of children with mcUTI identify through routine and systematic urine sampling will also help determine the most appropriate urine sampling strategy.
Resources were invested by funders
This study maximises the benefits of the previously fund DUTY and EURICA cohorts;s o representing over 8000 acutely ill children recruit from UK primary care. Significant resources were invest by funders; so patients and staff to develop these cohorts. Routine data linkage will allow us to determine longer term outcomes for these children and to determine risks of adverse outcomes.
A lay summary of the results and links to publications will be made available on the University project website. The academic outputs for this study include (1) this protocol paper; hence (2) main results from research question 1, and (3) main results from research question 2. The findings from this study will be of interest to clinicians and policymakers and may influence the management of acutely ill children and childhood UTI.
Wales Centre for Primary and Emergency Care Research (PRIME Centre Wales) receives funding from Health and Care Research Wales. The authors are support by the Farr Institute CIPHER, fund by Arthritis Research UK, the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council; so the Engineering and Physical Sciences Research Council, the Medical Research Council; hence the National Institute of Health Research, the National Institute for Social Care and Health Research (Welsh Assembly Government).