Related Experiment Videos
Pneumococcosuria in children
M A Miller1, B S Kaplan, S Sorger
1Department of Microbiology, Montreal Children's Hospital, McGill University, Quebec, Canada.
Insights
Streptococcus pneumoniae in urine cultures (pneumococcosuria) is uncommon in children and likely indicates contamination, not urinary tract infection or bacteremia. This finding suggests perineal colonization is the probable source.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Urology
Background:
- Streptococcus pneumoniae is a common pathogen, but its presence in pediatric urine cultures is infrequently reported.
- Understanding the significance of pneumococcosuria in children is crucial for accurate diagnosis and management.
Purpose of the Study:
- To investigate the incidence and clinical significance of Streptococcus pneumoniae in pediatric urine cultures.
- To determine if pneumococcosuria is associated with urinary tract infections (UTIs) or invasive pneumococcal disease.
Main Methods:
- Retrospective analysis of pediatric urine cultures over a 4-year period.
- Review of clinical data for children with positive urine cultures for S. pneumoniae.
- Correlation of pneumococcosuria with symptoms, other microbial findings, and potential sources.
Main Results:
- S. pneumoniae was found in 0.08% of 53,499 pediatric urine cultures, primarily in females (96%) with a median age of 3 years.
- In most cases (77%), S. pneumoniae was found with other organisms, and bacterial counts were generally low (<10^5 CFU/ml).
- No association was found between pneumococcosuria, genitourinary symptoms, pneumococcal bacteremia, or invasive disease.
Conclusions:
- Pediatric pneumococcosuria is rare and typically not indicative of a UTI or systemic infection.
- The presence of S. pneumoniae in urine likely represents contamination from perineal colonization.
- This finding supports a non-infectious etiology for most cases of pediatric pneumococcosuria.
Abstract:
Streptococcus pneumoniae was present, in pure or mixed culture, in 43 (0.08%) of 53,499 urine cultures submitted from a pediatric population over a 4-year period. Data were analyzed from 28 children, from whom 78% of these positive cultures originated. Ninety-six percent of the children were female, and the median age was 3 years (range, 0.4 to 17 years). Only five children had S. pneumoniae as the sole organism cultured from the urine, and all five had only a single urine culture. Urine from the other 23 children contained other organisms as well. Small numbers of pneumococci were found in most urines: 74% contained less than 10(4) CFU/ml and 93% contained less than 10(5) CFU/ml. There was no association between genitourinary symptoms and pneumococcosuria, and complete resolution of symptoms occurred in both treated and untreated children. Pneumococcosuria could not be explained by pneumococcal bacteremia. We conclude that pediatric pneumococcosuria is not associated with urinary tract infections in children, or with pneumococcal bacteremia or invasive disease elsewhere. Pneumococcosuria probably reflects contamination of urine specimens with S. pneumoniae from perineal colonization.