title: Hospital-acquired urinary tract infections in the pediatric patient: a prospective study.
abstract: To determine through a prospective study the characteristics of hospital-acquired urinary tract infections (HAUTI) in children, 525 children subjected to bladder catheterization during a hospital admission were identified through surveillance of 12,316 admissions during a 24-month period. Urine culture results were available for 296 (56.4%) of the catheterized patients. In addition 12 noncatheterized children with a documented HAUTI were identified. The clinical courses of all patients with a HAUTI were followed for at least 6 months after their last HAUTI during the study period. Forty-four patients, 1 week to 17 years of age, with 1 or more HAUTI during a hospital unit admission were identified. A total of 51 HAUTI occurred. Thirty-nine (76.5%) of the infections occurred in patients subjected to catheterization. Thirty-two (10.8%) of 296 catheterized patients developed a HAUTI. Forty-three (84.3%) of the 51 infections were single organism infections. One HAUTI was associated with a wound infection with the same organism and one with a concurrent bacteremia with the same organism. Relapses were seen after 4 HAUTI. One reinfection was identified. There were no deaths directly associated with a HAUTI. Hospitalized children subjected to urinary tract catheterization are at significant risk for HAUTI. Complications are infrequent and not life-threatening.
authors.affiliation: Division of Community Pediatrics, University of North Carolina School of Medicine, Chapel Hill 27599.
authors.forename: J A
authors.initials: JA
authors.lastname: Lohr
authors.forename: S M
authors.initials: SM
authors.lastname: Downs
authors.forename: S
authors.initials: S
authors.lastname: Dudley
authors.forename: L G
authors.initials: LG
authors.lastname: Donowitz
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000652:urine; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D014546:Urinary Catheterization / Q000009:adverse effects*; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology / Q000652:urine; D014768:Virginia / Q000453:epidemiology