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The age-related risk of co-existing meningitis in children with urinary tract infection

Marc Tebruegge1, Anastasia Pantazidou, Vanessa Clifford

  • 1Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia. marc.tebruegge@rch.org.au

Plos One
|November 19, 2011
PubMed

Insights

Bacterial meningitis co-infection is rare in children with urinary tract infections (UTI) after the neonatal period. However, neonates with UTI have a small but significant risk of meningitis, warranting prompt investigation.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Neonatology

Background:

  • Urinary tract infections (UTI) are common in children.
  • Bacterial meningitis is a serious infection that can co-occur with UTI.
  • Age-stratified risk assessment is crucial for diagnosing co-existing meningitis in children with UTI.

Purpose of the Study:

  • To determine the incidence of bacterial meningitis in children with UTI, stratified by age.
  • To identify common UTI pathogens and clinical features of co-existing meningitis.

Main Methods:

  • Retrospective analysis of a nine-year dataset from a tertiary pediatric hospital in Australia.
  • Inclusion criteria: children under 16 with culture-confirmed UTI and paired cerebrospinal fluid (CSF) samples.
  • Data analysis focused on age-stratified rates of co-existing meningitis.

Main Results:

  • 748 UTI episodes in 735 children were analyzed. Escherichia coli was the most common UTI pathogen (67.4%).
  • Two neonates (1.2%) aged 0-28 days with UTI had meningitis; both recovered fully.
  • No meningitis cases were found in infants (29 days-12 months) or older children with UTI.

Conclusions:

  • Neonates with UTI have a non-negligible risk of co-existing meningitis, suggesting a low threshold for lumbar puncture.
  • In children older than the neonatal period, the risk of meningitis with UTI is low, supporting a more selective diagnostic approach.
Abstract

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