title: Urinary Imaging Findings in Young Infants With Bacteremic Urinary Tract Infection.
abstract: To describe renal ultrasound (RUS) and voiding cystourethrogram (VCUG) findings and determine predictors of abnormal imaging in young infants with bacteremic urinary tract infection (UTI).
  
  
  
  We used retrospective data from a multicenter sample of infants younger than 3 months with bacteremic UTI, defined as the same pathogenic organism in blood and urine. Infants were excluded if they had any major comorbidities, known urologic abnormalities at time of presentation, required intensive unit care, or had no imaging performed. Imaging results as stated in the radiology reports were categorized by a pediatric urologist.
  
  
  
  Of the 276 infants, 19 were excluded. Of the remaining 257 infants, 254 underwent a RUS and 224 underwent a VCUG. Fifty-five percent had ≥1 RUS abnormalities. Thirty-four percent had ≥1 VCUG abnormalities, including vesicoureteral reflux (VUR, 27%), duplication (1.3%), and infravesicular abnormality (0.9%). Age <1 month, male sex, and non-Escherichia coli organism predicted an abnormal RUS, but only non-E coli organism predicted an abnormal VCUG. Seventeen of 96 infants (17.7%) with a normal RUS had an abnormal VCUG: 15 with VUR (Grade I-III = 13, Grade IV = 2), 2 with elevated postvoid residual, and 1 with infravesical abnormality.
  
  
  
  Although RUS and VCUG abnormalities were common in this cohort, the frequency and severity were similar to previous studies of infants with UTIs in general. Our findings do not support special consideration of bacteremia in imaging decisions for otherwise well-appearing young infants with UTI.
authors.affiliation: Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington; pearlchangmd@gmail.com.|Department of Pediatrics, Kaiser Permanente Northern California, Oakland, California.
authors.forename: Pearl W
authors.initials: PW
authors.lastname: Chang
authors.affiliation: Departments of Urology, and.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Abidari
authors.affiliation: Department of Pediatrics, Dell Children's Medical Center, Austin, Texas.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Shen
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Kaiser Permanente Northern California, San Francisco, California.
authors.forename: Tara L
authors.initials: TL
authors.lastname: Greenhow
authors.affiliation: Department of Pediatrics, Children's Hospital and Clinics of Minnesota, Minneapolis, Minnesota.
authors.forename: Michael
authors.initials: M
authors.lastname: Bendel-Stenzel
authors.affiliation: Department of Pediatrics, University of Texas Southwestern, Dallas, Texas.
authors.forename: Heidi K
authors.initials: HK
authors.lastname: Roman
authors.affiliation: Department of Pediatrics, University of Rochester, Rochester, New York; and.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Biondi
authors.affiliation: Pediatrics, Santa Clara Valley Medical Center, San Jose, California.|Department of Pediatrics, Stanford University School of Medicine, Stanford, California.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Schroeder
mesh_terms: D000070621:Cystography; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D012189:Retrospective Studies; D014521:Urethra / Q000000981:diagnostic imaging*; D014552:Urinary Tract Infections / Q000150:complications*; D014564:Urogenital Abnormalities / Q000175:diagnosis; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis