Prevalence of urinary tract infection in febrile young children in the emergency department.
OBJECTIVE
Establish prevalence rates of urinary tract infection (UTI) in febrile infants and young girls in an emergency department (ED) by demographics and clinical parameters.


METHODS
Cross-sectional prevalence survey of 2411 (83%) of all infants younger than 12 months and girls younger than 2 years of age presenting to the ED with a fever (>/=38.5 degrees C) who did not have a definite source for their fever and who were not on antibiotics or immunosuppressed. Otitis media, gastroenteritis, and upper respiratory infection were considered potential but not definite sources of fever.


RESULTS
Overall prevalence of UTI (growth of >/=10(4) CFU/mL of a urinary tract pathogen) was 3.3% (95% confidence interval [CI]: 2.6,4.0). Higher prevalences occurred in whites (10.7%; 95% CI: 7.1,14.3), girls (4.3%; 95% CI: 3.3,5.3), uncircumcised boys (8.0%; 95% CI: 1.9,14.1), and those who did not have another potential source for their fever (5.9%; 95% CI: 3.8,8. 0), had a history of UTI (9.3%; 95% CI: 3.0,20.3), malodorous urine or hematuria (8.6%; 95% CI: 2.8,19.0), appeared "ill" (5.7%; 95% CI: 4.0,7.4), had abdominal or suprapubic tenderness on examination (13. 2%; 95% CI: 3.7,30.7), or had fever >/=39 degrees C (3.9%; 95% CI: 3. 0,4.8). White girls had a 16.1% (95% CI: 10.6,21.6) prevalence of UTI.


CONCLUSIONS
UTI is prevalent in young children, particularly white girls, without a definite source of fever. Specific clinical signs and symptoms of UTI are uncommon, and the presence of another potential source of fever such as upper respiratory infection or otitis media is not reliable in excluding UTI.
Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
K N
KN
Shaw
M
M
Gorelick
K L
KL
McGowan
N M
NM
Yakscoe
J S
JS
Schwartz
D001741:Black or African American / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D002944:Circumcision, Male / Q000706:statistics & numerical data; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005334:Fever / Q000209:etiology; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D015143:Philadelphia / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D011446:Prospective Studies; D017678:Sex Distribution; D014552:Urinary Tract Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D044465:White People / Q000706:statistics & numerical data