Investigation of the rate of meningitis in association with urinary tract infection in infants 90�days of age or younger
ABSTRACT To test the hypothesis that urinary tract infections (UTI) in young infants are rarely associated with meningitis.
We undertook a review of the laboratory results from 322 infants, 90 days of age or younger, with an admission or discharge diagnosis of UTI or meningitis. The study was conducted in a tertiary paediatric hospital. The primary outcome measure was the incidence of coexisting urinary tract and cerebrospinal fluid sepsis.
In total, 161 of the 322 (50%) infants with an admission or discharge diagnosis of UTI or meningitis were subsequently shown to have a culture-proven UTI. Of the children with a culture-proven UTI, 75 (47%) had cerebrospinal fluid obtained. We detected one case of probable bacterial meningitis in association with UTI.
UTI is rarely associated with meningitis in infants 90 days of age or younger.
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ABSTRACT: Our aim is to reduce the rate of lumbar spinal tapping and voiding cystourethrography (VCUG) in febrile urinary tract infection (UTI) infants less than 3 months of age.Journal of the Korean Society of Pediatric Nephrology 01/2009; 13(1). DOI:10.3339/jkspn.2009.13.1.33
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ABSTRACT: To determine the incidence of sterile cerebrospinal fluid (CSF) pleocytosis in infants ≤6 months old with urinary tract infection (UTI). Retrospective study of children admitted to a tertiary children's hospital in 2006 and 2007 with UTI who also had a lumbar puncture performed. All urine specimens were tested for anti-microbial activity. Twelve (11.3%) of 106 infants with UTI had concurrent CSF pleocytosis. None of these patients had anti-microbial activity in the urine, showing that they had not received prior antibiotics. None of the 15 neonates (≤28 days old) with UTI and lumbar puncture had CSF pleocytosis. Antibiotics were stopped after a maximum of 10 days. Our results are compatible with published reports on the proportion of infants with UTI who have concurrent sterile CSF pleocytosis. We were able to exclude previous antibiotic therapy by measuring urinary anti-microbial activity. Our work supports the hypothesis that CSF pleocytosis in UTI is inflammatory and not because of infection of the central nervous system.Journal of Paediatrics and Child Health 05/2009; 45(6):364-7. DOI:10.1111/j.1440-1754.2009.01502.x · 1.19 Impact Factor
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ABSTRACT: The goal was to examine the feasibility of outpatient management for 1- to 3-month-old infants with febrile urinary tract infections. A cohort study was performed with all children 30 to 90 days of age who were evaluated for presumed febrile urinary tract infections in the emergency department of a tertiary-care pediatric hospital between January 1, 2005, and September 30, 2007. Patients were treated with intravenously administered antibiotics as outpatients in a day treatment center unless they met exclusion criteria, in which case they were hospitalized. Of 118 infants included in the study, 67 (56.8%) were admitted to the day treatment center and 51 (43.2%) were hospitalized. The median age of day treatment center patients was 66 days (range: 33-85 days). The diagnosis of urinary tract infection was confirmed for 86.6% of patients treated in the day treatment center. Escherichia coli was identified in 84.5% of urine cultures; 98.3% of isolates were sensitive to gentamicin. Six blood cultures (10.3%) yielded positive results, 5 of them for E coli. Treatment with intravenously administered antibiotics in the day treatment center lasted a mean of 2.7 days. The mean number of visits, including appointments for voiding cystourethrography, was 2.9 visits. The rate of parental compliance with day treatment center visits was 98.3%. Intravenous access problems were seen in 8.6% of cases. Successful treatment in the day treatment center (defined as attendance at all visits, normalization of temperature within 48 hours, negative control urine and blood culture results, if cultures were performed, and absence of hospitalization from the day treatment center) was obtained for 86.2% of patients with confirmed urinary tract infections. Ambulatory treatment of infants 30 to 90 days of age with febrile urinary tract infections by using short-term, intravenous antibiotic therapy at a day treatment center is feasible.PEDIATRICS 08/2009; 124(1):16-22. DOI:10.1542/peds.2008-2583 · 5.30 Impact Factor