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UTI rates low among infants with RSV infections
When using the 2011 AAP diagnostic criteria for urinary tract infections, researchers found that the rate of urinary tract infections among respiratory syncytial virus-positive infants was very low, according to recent study findings published in Clinical Pediatrics.
The 2011 AAP guidelines on UTI requires the presence of pyuria and at least 50,000 colony-forming units (CFU)/mL of a single uropathogenic organism.
Dinushan Kaluarachchi, MD, of the department of pediatrics at Lincoln Medical and Mental Health Center, Bronx, N.Y., and colleagues evaluated 359 children, nearly 60% of whom were aged 2 to 6 months (59.1% boys), to determine the rate of UTIs among febrile infants with RSV based on 2011 AAP diagnostic criteria compared with the 1999 AAP diagnostic criteria.
A maximum temperature of 102.2°F or more was present in almost half of the patients and most had a low white blood cell count (<15,000/mcL) and low absolute neutrophil count (<10,000/mm3).
Urinary catheterization under sterile conditions was used to obtain all urine cultures. Forty patients had pyuria, 17 had a urine culture of at least 50,000 CFU/mL and five patients had a urine culture of 10,000 CFU/mL to 50,000 CFU/mL. Twenty-two patients were identified as having a UTI using the 1999 AAP diagnostic criteria compared with four using the 2011 AAP diagnostic criteria. Positive urine cultures were only found in seven of the patients with pyuria.
The most common bacteria grown on urine cultures were Escherichia coli, followed by Klebsiella pneumoniae and Enterococcus spp.
“The rate of UTIs in RSV-positive febrile infants is very low (1.1%) with the 2011 AAP diagnostic criteria,” the researchers wrote. “Previously described increased risk of UTIs may represent asymptomatic bacteriuria or contaminated specimens. We suggest that clinicians should be less inclined to test febrile infants with RSV infections for UTIs.”
Disclosure: The researchers report no relevant financial disclosures.
