Defining urinary tract infection in the critically ill child

Area of Science:

• Pediatric critical care medicine
• Infectious disease epidemiology
• Clinical definitions and diagnostics

Background:

• Urinary tract infections (UTIs) are common in critically ill children.
• Existing UTI definitions lack standardization for intensive care unit (ICU) populations.
• Consistent definitions are crucial for accurate infection surveillance and clinical trial enrollment.

Purpose of the Study:

• To establish consensus-based definitions for UTIs in critically ill children within the ICU setting.
• To facilitate standardized surveillance of infections.
• To enable consistent enrollment of pediatric patients in sepsis and therapeutic trials.

Main Methods:

• A comprehensive literature review was conducted.
• Expert consensus was achieved through a review process.
• Validated definitions for febrile children and existing criteria were considered.

Main Results:

• Multiple UTI definitions were identified, with varying levels of validation in pediatric populations.
• Centers for Disease Control criteria for nosocomial infections were noted for surveillance.
• Consensus-derived definitions for definite, possible, and probable UTI were developed based on clinical, symptomatic, and laboratory criteria.

Conclusions:

• Consensus definitions for definite, probable, and possible UTI in critically ill children have been established.
• These definitions can be applied for infection surveillance and enrollment in sepsis trials.
• Future research should validate and adapt these definitions for the specific needs of critically ill pediatric patients.