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A Study to Determine the Incidence of Urinary Tract Infections in Infants and Children Ages 4 Months to 6 Years With
1New York Medical College, Metropolitan Hospital Center, New York, NY, USA.
Insights
Febrile diarrhea in young children does not increase the risk of urinary tract infections (UTIs). This study found no UTIs in infants and children presenting with fever and diarrhea.
Area of Science:
- Pediatrics
- Infectious Diseases
- Urology
Background:
- Febrile diarrhea is a common pediatric condition.
- Urinary tract infections (UTIs) can present with fever.
- The relationship between febrile diarrhea and UTIs in young children requires clarification.
Purpose of the Study:
- To determine the incidence of urinary tract infections (UTIs) in infants and children aged 4 months to 6 years presenting with febrile diarrhea as outpatients.
Main Methods:
- Prospective study of 80 outpatients (4 months to 6 years) with fever (≥101°F) and diarrhea.
- Urine samples collected via bladder catheterization or midstream clean catch.
- Urine analysis and culture performed.
Main Results:
- No organisms grew in any urine cultures, regardless of collection method.
- No increased incidence of UTIs was observed in male children (circumcised or uncircumcised).
- The statistical analysis showed a highly significant result (P < .0001).
Conclusions:
- Febrile diarrhea in infants and children (4 months to 6 years) is not associated with an increased incidence of UTIs.
- Routine urine culture may not be necessary for this patient population presenting with these symptoms.
Objective:
To determine the incidence of urinary tract infections (UTIs) in infants and children (4 months to 6 years of age) with febrile diarrhea, as outpatients.
Methods:
This was a prospective institutional review board-approved study. patients (between 4 months and 6 years of age) were enrolled in the study who presented to the pediatric emergency room with a complaint of fever (rectal temperature 101°F or more) and diarrhea (watery stools >3 in number). The patients were evaluated for state of hydration, and also urine samples were collected. For those children not toilet trained, urine specimens were collected by bladder catheterization, and for those children toilet trained, urine specimens were obtained by midstream collection method. The urine samples obtained were sent for analysis and culture.
Results:
Eighty patients were enrolled in the study. The number of specimens obtained by clean catch midstream was 20, and by bladder catheterization was 60. None of the urine specimens obtained by both methods of collection grew any organism. There was no increased incidence of infections in male children whether circumcised (10/60) or uncircumcised (50/60). The mean temperature was 102.8°F (range = 101°F to 105°F).
Statistics:
Using in silico online 2 × 2 χ(2) test by comparing both the positive and negative urine culture results, 2-tailed P value is <.0001.
Conclusions:
Our prospective randomized study concluded that there is no increased incidence of UTIs in infants and children (4 months to 6 years of age) with febrile diarrhea.
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