Assessing the Utility of Urine Testing in Febrile Infants Aged 2 to 12 Months With Bronchiolitis

Pediatr Emerg Care. 2015 Sep;31(9):616-20. doi: 10.1097/PEC.0000000000000359.

Abstract

Objectives: 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.

MeSH terms

  • Bacteriuria / epidemiology
  • Bacteriuria / microbiology
  • Bronchiolitis / diagnosis
  • Bronchiolitis / epidemiology
  • Bronchiolitis / urine*
  • Cohort Studies
  • Culture Techniques / methods
  • Culture Techniques / statistics & numerical data
  • Emergency Service, Hospital
  • Escherichia coli / isolation & purification
  • Female
  • Fever / diagnosis
  • Fever / epidemiology
  • Fever / urine*
  • Humans
  • Incidence
  • Infant
  • Male
  • Prevalence
  • Prospective Studies
  • United States / epidemiology
  • Urinalysis / methods
  • Urinalysis / statistics & numerical data
  • Urinary Tract Infections / diagnosis
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / microbiology
  • Urinary Tract Infections / urine*