title: Prevalence of urinary tract infection (UTI) in sequential acutely unwell children presenting in primary care: exploratory study.
abstract: BACKGROUND
  Due to the non-specific nature of symptoms of UTI in children and low levels of urine sampling, the prevalence of UTI amongst acutely ill children in primary care is unknown.
  
  
  OBJECTIVE
  To undertake an exploratory study of acutely ill children consulting in primary care, determine the feasibility of obtaining urine samples, and describe presenting symptoms and signs, and the proportion with UTI.
  
  
  METHODS
  Exploratory, observational study.
  
  
  METHODS
  Four general practices in South Wales.
  
  
  METHODS
  A total of 99 sequential attendees with acute illness aged less than five years.
  
  
  METHODS
  UTI defined by >10(5) organisms/ml on laboratory culture of urine.
  
  
  RESULTS
  Urine samples were obtained in 75 (76%) children. Three (4%) met microbiological criteria for UTI. GPs indicated they would not normally have obtained urine samples in any of these three children. However, all had received antibiotics for suspected alternative infections.
  
  
  CONCLUSIONS
  Urine sample collection is feasible from the majority of acutely ill children in primary care, including infants. Some cases of UTI may be missed if children thought to have an alternative site of infection are excluded from urine sampling. A larger study is needed to more accurately determine the prevalence of UTI in children consulting with acute illness in primary care, and to explore which symptoms and signs might help clinicians effectively target urine sampling.
authors.affiliation: The Department of Primary Care and Public Health, School of Medicine, Cardiff University, Heath Park, Cardiff, Wales, UK. obrienka@cf.ac.uk
authors.forename: Kathryn
authors.initials: K
authors.lastname: O'Brien
authors.forename: Naomi
authors.initials: N
authors.lastname: Stanton
authors.forename: Adrian
authors.initials: A
authors.lastname: Edwards
authors.forename: Kerenza
authors.initials: K
authors.lastname: Hood
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Butler
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D005260:Female; D058006:General Practice; D006801:Humans; D007223:Infant; D008297:Male; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D011320:Primary Health Care; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology / Q000652:urine; D014852:Wales / Q000453:epidemiology