Abstract
Background
Siblings of children with vesicoureteral reflux (VUR) are at elevated risk of VUR.
Screening siblings may identify VUR before a clinical illness such as a urinary tract
infection (UTI), but the benefit of screening has not been demonstrated. We sought
to determine the incidence of UTI among siblings, and we hypothesized that the sibling
UTI rate is similar between screened and unscreened siblings.
Methods
We performed a retrospective cohort analysis using insurance claims data (January
1, 2000, to December 31, 2009). Within each family, we identified the index VUR patient
and siblings; we included siblings who were enrolled in the insurance plan from birth
for at least 1 year. We identified siblings who were screened for VUR and/or had UTI.
We investigated the association of screening and UTI, controlling for patient characteristics
and clustering within families.
Results
Among 617 siblings (associated with 497 index patients), 317 (51%) were girls. Median
insurance enrollment time was 53.0 months, with 424 enrolled ≥3 years. Among those
with 1 or 3 years of enrollment, the proportions of siblings who experienced UTI was
8.4% (52 of 617) and 10.4% (44 of 424), respectively. Median age at initial UTI was
32.7 months. A total of 223 siblings (36.0%) underwent sibling screening. There was
no significant difference in UTI between screened and unscreened siblings (odds ratio
1.57, 95% confidence interval 0.87–2.85; P = .14). In multivariate analysis, screening was not associated with sibling UTI incidence
(odds ratio 1.33, 95% confidence interval 0.68–2.60; P = .40).
Conclusions
Although UTI is relatively common among siblings of VUR patients, there was no statistically
significant difference in UTI incidence between screened and unscreened siblings.
Keywords
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Article Info
Publication History
Published online: November 14, 2015
Accepted:
November 10,
2015
Received:
May 1,
2015
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
Copyright © 2016 by Academic Pediatric Association
