Bacteremic vs nonbacteremic urinary tract infection in children

Bacteremia is an uncommon complication of urinary tract infection (UTI). The aim of this study was to identify risk factors for bacteremic UTI in pediatric patients.

The medical records of all pediatric patients with UTI between 2013 and 2014 were retrospectively reviewed. Pediatric patients with accompanying bacteremia were compared with pediatric patients with no bacteremia.

Five hundred twenty-seven cases of UTI were identified. Blood cultures were taken in 464, 26 (5.6%) of which also were bacteremic. Pediatric patients with bacteremia were more likely to be male (58% vs 28%, P<.01), to be younger than 3 months (54% vs 31%, P=.02), and to have higher creatinine (average 0.77±0.97 vs 0.34±0.24, P<.01). Pediatric patients with bacteremia had higher rate of underlying urologic conditions. The following variables were included in multivariate analysis: age <3months, sex, ethnicity, method of urine collection, creatinine, and underlying urologic conditions. Only creatinine (odds ratio, 3.67; 95% confidence interval, 1.69-8.11) was found as an independent risk factor for bacteremia.

High creatinine at presentation is a risk factor that might aid in early identification of pediatric patients with high risk for bacteremia and its complications.