Urinary Tract Infection in Febrile Infants Younger Than Eight Weeks of Age

• DOI: 10.1542/peds.105.2.e20
• Publication Date: 2004-08-13T23:50:41Z
• Authors: Dar-Shong Lin; Shing-Huey Huang; Chun-Chun Lin; Yi-Chen Tung; Tsu-Tzu Huang; Nan-Chang Chiu; Hsin-An Koa; Han-Yang Hung; Chyong-Hsin Hsu; Wen-Shyang Hsieh; Dien-Ie Yang; Fu-Yuan Huang
• Keywords: Hemocytometer; Pyuria; White blood cell; Erythrocyte sedimentation rate; Leukocytosis

Objective. To assess the usefulness of laboratory parameters, including peripheral white blood cell (WBC) count, C-reactive protein (CRP) concentration, erythrocyte sedimentation rate (ESR), and microscopic urinalysis (UA), for identifying febrile infants younger than 8 weeks age at risk urinary tract infection (UTI), comparison standard UA hemocytometer WBC counts predicting presence UTI. Methods. A total 162 children <8 were enrolled in this prospective study. All underwent clinical evaluation investigation, count differential; ESR; CRP; culture; a lumbar puncture differential, glucose level, Gram stain, urine culture. specimens obtained by suprapubic aspiration microscopically analyzed with as well counts. Quantitative cultures performed. Sensitivity, specificity, accuracy, likelihood ratios, receiver operating characteristic (ROC) curves determined each screening tests. Results. There 22 positive culture results least 100 colony-forming unit/mL. Eighteen these patients males, all uncircumcised. significant differences pyuria ≧5 WBCs/hpf, ≧10 WBC/μL, CRP >20 mg/L, ESR >30 mm/hour between culture-positive culture-negative groups (P < .05). The ROC area UA, ESR, concentration .909 ± .045, .791 .065, .544 .074, .787 .060, .822 .036, respectively. curve analysis indicates that CRP, powerful but imperfect tools which to discriminate UTI potentially infected neonates. Hemocytometer had highest sensitivity, ratios very young results. For assessments, significantly different, compared urinalysis. not helpful infants. Conclusion. prevalence 13.6% age. discriminating UTI, sensitivity parameters was relatively low. better predictor