title: Assessing the Utility of Urine Testing in Febrile Infants Aged 2 to 12 Months With Bronchiolitis.
abstract: OBJECTIVE
  The aims of the study were to investigate whether the prevalence of urinary tract infections (UTIs) in febrile infants aged 2 to 12 months with bronchiolitis is higher than the presumed prevalence of asymptomatic bacteriuria (1%) in similarly aged patients and thus to determine whether UTI testing is necessary for these patients.
  
  
  METHODS
  This was a prospective cohort study in which we enrolled a convenience sample of febrile infants aged 2 to 12 months with a clinical diagnosis of bronchiolitis. All patients were seen in the emergency department at a large children's hospital between November 1, 2011 and April 15, 2012, had reported or documented fever higher than 38°C, and had urine collected for determination of the presence of UTI. After the conclusion of enrollment, a chart review was conducted to assess missed cases.
  
  
  RESULTS
  Positive urine cultures were found in 6/90 (6.7%) patients (confidence interval, 2.5%-13.9%). The positive urine cultures and urinalysis results were found in 4/90 (4.5%) patients (confidence interval, 1.2%-11%).
  
  
  CONCLUSIONS
  In our patient population, a significant proportion of infants aged 2 to 12 months who present with bronchiolitis and fever have a concurrent UTI. Obtaining a urine specimen for UTI testing should be considered in infants aged 2 to 12 months with bronchiolitis and fever. A larger multicenter study is needed to further assess the risk factors for UTIs in this patient population.
authors.affiliation: From the Division of Emergency Medicine, Children's Hospital Los Angeles Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Marsha A
authors.initials: MA
authors.lastname: Elkhunovich
authors.forename: Vincent J
authors.initials: VJ
authors.lastname: Wang
mesh_terms: D001437:Bacteriuria / Q000453:epidemiology / Q000382:microbiology; D001988:Bronchiolitis / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine*; D015331:Cohort Studies; D046508:Culture Techniques / Q000379:methods / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology; D016482:Urinalysis / Q000379:methods / Q000706:statistics & numerical data; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000652:urine*