All issues > Volume 46(3); 2003

Original Article

J Korean Pediatr Soc. 2003;46(3):265-270. Published online March 15, 2003.

Urinary Tract Infections in Febrile Infants under Three Months of Age

Byung Wook BW Eun¹, Yoo Mi YM Chung¹, Hee Gyung HG Kang¹, Il Soo IS Ha¹, Hae Il HI Cheong¹, Hoan Jong HJ Lee¹, Yong Y Choi¹

¹Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea

Correspondence Yong Y Choi ,Email: ychoi@plaza.snu.ac.kr

Abstract

Purpose
: To characterize the infants under 3 months of age with urinary tract infections(UTIs), and especially patients with bacteremia or meningitis
Methods
: Hospital records of all the infants under 3 months of age discharged from our hospital for 69 consecutive months with the diagnosis of initial episode of UTI were reviewed. UTI was defined when patients had fever with pyuria, and had urine culture results of ≥105 colony forming units/mL from a bag specimen. Patients with previously known urologic abnormality or immunodeficiency were excluded. Nosocomial infections were also excluded from the study.
Results
: The male:female ratio was 35 : 6. Of the urine cultures, 40(97.6%) yielded single pathogen, one yielded two pathogens. Escherichia coli was the predominant isolate from the urine. Five patients(12%) also had bacteremia. Pathogens isolated from the blood cultures were E. coli(4) and Enterococcus faecalis(1). No patient had culture-positive meningitis or cerebrospinal fluid pleocytosis. Clinical or laboratory findings between patients with and without bacteremia were not different significantly. The rate of vesicoureteral reflux(VUR) was 44%. The sensitivity of ultrasound for detection of VUR was 38%; specificity was 50%.
Conclusion
: Clinical and laboratory data were not helpful for identifying patients with bacteremia at the time of presentation. Consequently, blood cultures need to be obtained from all febrile infants under 3 months of age with UTIs. A large-scale study including the indication of lumbar puncture for infants with a febrile UTI and study of evaluation and treatment of infants under 3 months of age with UTIs are required.

Keywords :Urinary tract infections, Febrile infants, Bacteremia, Meningitis