Association between vesicoureteral reflux, urinary tract infection and antibiotics exposure in infancy and risk of childhood asthma.

<h4>Background</h4>The use of antibiotics for treating infection in childhood and their association with increased risk of asthma remain controversial. Infants diagnosed with vesicoureteral reflux (VUR) belong to a unique population who are administered antibiotics for a long time and ar...

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Autores principales:	Yu-Lung Hsu, Cheng-Li Lin, Chang-Ching Wei
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/099b4120146744a0a167fe7e639560f3
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spelling	oai:doaj.org-article:099b4120146744a0a167fe7e639560f32021-12-02T20:14:26ZAssociation between vesicoureteral reflux, urinary tract infection and antibiotics exposure in infancy and risk of childhood asthma.1932-620310.1371/journal.pone.0257531https://doaj.org/article/099b4120146744a0a167fe7e639560f32021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0257531https://doaj.org/toc/1932-6203<h4>Background</h4>The use of antibiotics for treating infection in childhood and their association with increased risk of asthma remain controversial. Infants diagnosed with vesicoureteral reflux (VUR) belong to a unique population who are administered antibiotics for a long time and are susceptible to recurrent UTI. It is interesting to study the risk of asthma in these infants with or without VUR.<h4>Methods</h4>Taiwanese children born between 2000 and 2007 were enrolled in population-based birth cohort study. Participants diagnosed with VUR and UTI within first year were classified into four groups (VUR, UTI, VUR and UTI, and control). We calculated follow-up person-years for each participant from the index date until the asthma diagnosis, their withdrawal from the insurance system (because of death or loss to follow-up), or till the end of 2008. The risk of asthma was compared between the 4 cohorts by using Cox proportional hazards model analysis, adjusted hazard ratio (aHR), and 95% confidence interval (95% CI).<h4>Results</h4>Children diagnosed with VUR (n = 350), UTI (n = 15542), VUR and UTI (n = 1696), and randomly selected controls (n = 17588) were enrolled. The overall rate of incidence of asthma was found to be 1.64-fold, 1.45-fold, and 1.17-fold higher in the UTI, VUR/UTI, and VUR cohorts than in the controls (5.60, 5.07, and 4.10 vs. 3.17 per 100 person-years), respectively. After adjusting the potential factors, the overall risk of asthma remained the highest in UTI (aHR: 1.74, 95% CI : 1.65 to 1.80) followed by VUR/UTI (aHR: 1.56, 95% CI : 1.40 to 1.75) and VUR cohorts (aHR: 1.25, 95% CI: 0.96 to 1.62). The incidence of asthma was higher in boys than in girls.<h4>Conclusion</h4>The nationwide retrospective cohort study demonstrated that short-term therapeutic dose of antibiotics for UTI in infants with or without VUR has a positive correlation with the prevalence of childhood asthma. Significant risk of childhood asthma was not observed when VUR cohort was exposed to long-term low-dose of prophylactic antibiotics.Yu-Lung HsuCheng-Li LinChang-Ching WeiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0257531 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yu-Lung Hsu Cheng-Li Lin Chang-Ching Wei Association between vesicoureteral reflux, urinary tract infection and antibiotics exposure in infancy and risk of childhood asthma.
description	<h4>Background</h4>The use of antibiotics for treating infection in childhood and their association with increased risk of asthma remain controversial. Infants diagnosed with vesicoureteral reflux (VUR) belong to a unique population who are administered antibiotics for a long time and are susceptible to recurrent UTI. It is interesting to study the risk of asthma in these infants with or without VUR.<h4>Methods</h4>Taiwanese children born between 2000 and 2007 were enrolled in population-based birth cohort study. Participants diagnosed with VUR and UTI within first year were classified into four groups (VUR, UTI, VUR and UTI, and control). We calculated follow-up person-years for each participant from the index date until the asthma diagnosis, their withdrawal from the insurance system (because of death or loss to follow-up), or till the end of 2008. The risk of asthma was compared between the 4 cohorts by using Cox proportional hazards model analysis, adjusted hazard ratio (aHR), and 95% confidence interval (95% CI).<h4>Results</h4>Children diagnosed with VUR (n = 350), UTI (n = 15542), VUR and UTI (n = 1696), and randomly selected controls (n = 17588) were enrolled. The overall rate of incidence of asthma was found to be 1.64-fold, 1.45-fold, and 1.17-fold higher in the UTI, VUR/UTI, and VUR cohorts than in the controls (5.60, 5.07, and 4.10 vs. 3.17 per 100 person-years), respectively. After adjusting the potential factors, the overall risk of asthma remained the highest in UTI (aHR: 1.74, 95% CI : 1.65 to 1.80) followed by VUR/UTI (aHR: 1.56, 95% CI : 1.40 to 1.75) and VUR cohorts (aHR: 1.25, 95% CI: 0.96 to 1.62). The incidence of asthma was higher in boys than in girls.<h4>Conclusion</h4>The nationwide retrospective cohort study demonstrated that short-term therapeutic dose of antibiotics for UTI in infants with or without VUR has a positive correlation with the prevalence of childhood asthma. Significant risk of childhood asthma was not observed when VUR cohort was exposed to long-term low-dose of prophylactic antibiotics.
format	article
author	Yu-Lung Hsu Cheng-Li Lin Chang-Ching Wei
author_facet	Yu-Lung Hsu Cheng-Li Lin Chang-Ching Wei
author_sort	Yu-Lung Hsu
title	Association between vesicoureteral reflux, urinary tract infection and antibiotics exposure in infancy and risk of childhood asthma.
title_short	Association between vesicoureteral reflux, urinary tract infection and antibiotics exposure in infancy and risk of childhood asthma.
title_full	Association between vesicoureteral reflux, urinary tract infection and antibiotics exposure in infancy and risk of childhood asthma.
title_fullStr	Association between vesicoureteral reflux, urinary tract infection and antibiotics exposure in infancy and risk of childhood asthma.
title_full_unstemmed	Association between vesicoureteral reflux, urinary tract infection and antibiotics exposure in infancy and risk of childhood asthma.
title_sort	association between vesicoureteral reflux, urinary tract infection and antibiotics exposure in infancy and risk of childhood asthma.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/099b4120146744a0a167fe7e639560f3
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Association between vesicoureteral reflux, urinary tract infection and antibiotics exposure in infancy and risk of childhood asthma.

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