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Repeat urine cultures in children who are admitted with urinary tract infections
Nicolas M Oreskovic1, Eduardo U Sembrano
1Department of Internal Medicine, Mount Sinai Hospital, 1 Gustave L. Levy Place, New York, NY 10029, USA. nicolas.oreskovic@gmail.com
Insights
Repeat urine cultures after 2 days of antibiotics are rare in pediatric urinary tract infections. This suggests that mandatory "proof-of-bacteriologic-cure" tests before hospital discharge may be unnecessary for these patients.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Hospital Medicine
Background:
- Urinary tract infections (UTIs) are a frequent reason for pediatric hospitalizations.
- Current management often includes intravenous antibiotics, invasive urine collection, and imaging studies.
Purpose of the Study:
- To determine the frequency of positive repeat urine cultures after 2 days of antibiotic treatment in hospitalized children with UTIs.
Main Methods:
- Retrospective survey of pediatric patients (<18 years) admitted with suspected or diagnosed UTIs.
- Data abstracted from computerized medical records (December 1998 - December 2004).
- Analysis focused on repeat urine culture results obtained after 2 days of antimicrobial therapy.
Main Results:
- 328 of 599 eligible admissions met inclusion criteria.
- Only 1 (0.3%) repeat urine culture was positive after 2 days of antibiotic therapy.
Conclusions:
- Positive repeat urine cultures are exceedingly rare in pediatric UTI patients treated with antibiotics.
- The study supports the elimination of mandatory "proof-of-bacteriologic-cure" benchmarks before hospital discharge.
Objective:
Urinary tract infections are a common cause of hospitalization in the pediatric population. Hospitalization for urinary tract infections in children usually involves intravenous antibiotics, invasive methods of obtaining sterile urine specimens, and imaging studies to assess the anatomy of the urinary system. The objective of this study was to determine the frequency of positive repeat urine cultures that are obtained after 2 days of antibiotics among pediatric inpatients who are admitted with diagnosed or suspected infections of the urinary tract.
Methods:
A retrospective survey was conducted of all pediatric patients (< or = 18 years of age) who were admitted to Elmhurst Hospital in Queens, New York, with a suspected or diagnosed urinary infection from December 1998 through December 2004. Results of repeat urine cultures that were obtained after 2 days of antibiotics were abstracted from a computerized medical charts database. Nominal data analysis was used to establish the frequency of positive repeat urine cultures.
Results:
A total of 328 (54.8%) of 599 eligible admissions met inclusion criteria. Of these 328 admissions, only 1 (0.3%) repeat urine culture was positive after 2 days of antimicrobial therapy.
Conclusions:
Positive repeat urine cultures after 2 days of antibiotics are exceedingly rare. Elimination of mandatory "proof-of-bacteriologic-cure" benchmarks before hospital discharge is supported by this study.
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