Testing for Urinary Tract Infection in the Influenza/Respiratory Syncytial Virus–Positive Febrile Infant Aged 2 to 12 Months

Anna Kathleen Schlechter Salinas, David Hains, Tamekia Jones, Camden Harrell, Mark Meredith

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

OBJECTIVE: Infants 12 months or younger with influenza and respiratory syncytial virus (RSV) commonly present to the emergency department (ED) with fever. Previous publications have recommended that these patients have a urinalysis and urine culture performed. We aimed to assess the prevalence of urinary tract infection (UTI) in febrile RSV/influenza positive infants aged 2 to 12 months presenting to the ED. We also examined whether the 2011 American Academy of Pediatrics (AAP) UTI clinical practice guidelines could be used to identify patients at lower risk of UTI. METHODS: This was a retrospective chart review examining all infants aged 2 to 12 months with a documented fever of higher than 38°C who presented to our ED from 2009 to 2013 and tested positive for influenza and/or RSV. RESULTS: One thousand seven hundred twenty-four patients were found to meet our inclusion criteria. Of these, 98 were excluded because of known urinary tract anomaly or systemic antibiotic use in the 24 hours preceding evaluation. Of those patients remaining, 10 (0.62%) of 1626 had positive urine cultures (95% confidence interval, 0.3%–1.1%), and 8 (0.49%) of 1626 (95% confidence interval, 0.2%–0.97%) had positive urine cultures with positive urinalyses as defined in the 2011 AAP UTI clinical practice guidelines. All subjects with positive urine cultures as defined by the AAP had risk factors for UTI that placed their risk for UTI above 1%. CONCLUSIONS: Our population of 2- to 12-month-old febrile infants with positive influenza/RSV testing, who did not have risk factors to make their risk of UTI higher than 1%, may not have required evaluation with urinalysis or urine culture.

Original languageEnglish (US)
JournalPediatric Emergency Care
DOIs
StateAccepted/In press - Mar 9 2017

Fingerprint

Urinary Tract Infections
Human Influenza
Fever
Respiratory Syncytial Viruses
Urine
Urinalysis
Hospital Emergency Service
Pediatrics
Practice Guidelines
Confidence Intervals
Urinary Tract
Anti-Bacterial Agents
Population

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

Cite this

Testing for Urinary Tract Infection in the Influenza/Respiratory Syncytial Virus–Positive Febrile Infant Aged 2 to 12 Months. / Schlechter Salinas, Anna Kathleen; Hains, David; Jones, Tamekia; Harrell, Camden; Meredith, Mark.

In: Pediatric Emergency Care, 09.03.2017.

Research output: Contribution to journalArticle

@article{efce667a8ca147efaf2206729af36f69,
title = "Testing for Urinary Tract Infection in the Influenza/Respiratory Syncytial Virus–Positive Febrile Infant Aged 2 to 12 Months",
abstract = "OBJECTIVE: Infants 12 months or younger with influenza and respiratory syncytial virus (RSV) commonly present to the emergency department (ED) with fever. Previous publications have recommended that these patients have a urinalysis and urine culture performed. We aimed to assess the prevalence of urinary tract infection (UTI) in febrile RSV/influenza positive infants aged 2 to 12 months presenting to the ED. We also examined whether the 2011 American Academy of Pediatrics (AAP) UTI clinical practice guidelines could be used to identify patients at lower risk of UTI. METHODS: This was a retrospective chart review examining all infants aged 2 to 12 months with a documented fever of higher than 38°C who presented to our ED from 2009 to 2013 and tested positive for influenza and/or RSV. RESULTS: One thousand seven hundred twenty-four patients were found to meet our inclusion criteria. Of these, 98 were excluded because of known urinary tract anomaly or systemic antibiotic use in the 24 hours preceding evaluation. Of those patients remaining, 10 (0.62{\%}) of 1626 had positive urine cultures (95{\%} confidence interval, 0.3{\%}–1.1{\%}), and 8 (0.49{\%}) of 1626 (95{\%} confidence interval, 0.2{\%}–0.97{\%}) had positive urine cultures with positive urinalyses as defined in the 2011 AAP UTI clinical practice guidelines. All subjects with positive urine cultures as defined by the AAP had risk factors for UTI that placed their risk for UTI above 1{\%}. CONCLUSIONS: Our population of 2- to 12-month-old febrile infants with positive influenza/RSV testing, who did not have risk factors to make their risk of UTI higher than 1{\%}, may not have required evaluation with urinalysis or urine culture.",
author = "{Schlechter Salinas}, {Anna Kathleen} and David Hains and Tamekia Jones and Camden Harrell and Mark Meredith",
year = "2017",
month = "3",
day = "9",
doi = "10.1097/PEC.0000000000001073",
language = "English (US)",
journal = "Pediatric Emergency Care",
issn = "0749-5161",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Testing for Urinary Tract Infection in the Influenza/Respiratory Syncytial Virus–Positive Febrile Infant Aged 2 to 12 Months

AU - Schlechter Salinas, Anna Kathleen

AU - Hains, David

AU - Jones, Tamekia

AU - Harrell, Camden

AU - Meredith, Mark

PY - 2017/3/9

Y1 - 2017/3/9

N2 - OBJECTIVE: Infants 12 months or younger with influenza and respiratory syncytial virus (RSV) commonly present to the emergency department (ED) with fever. Previous publications have recommended that these patients have a urinalysis and urine culture performed. We aimed to assess the prevalence of urinary tract infection (UTI) in febrile RSV/influenza positive infants aged 2 to 12 months presenting to the ED. We also examined whether the 2011 American Academy of Pediatrics (AAP) UTI clinical practice guidelines could be used to identify patients at lower risk of UTI. METHODS: This was a retrospective chart review examining all infants aged 2 to 12 months with a documented fever of higher than 38°C who presented to our ED from 2009 to 2013 and tested positive for influenza and/or RSV. RESULTS: One thousand seven hundred twenty-four patients were found to meet our inclusion criteria. Of these, 98 were excluded because of known urinary tract anomaly or systemic antibiotic use in the 24 hours preceding evaluation. Of those patients remaining, 10 (0.62%) of 1626 had positive urine cultures (95% confidence interval, 0.3%–1.1%), and 8 (0.49%) of 1626 (95% confidence interval, 0.2%–0.97%) had positive urine cultures with positive urinalyses as defined in the 2011 AAP UTI clinical practice guidelines. All subjects with positive urine cultures as defined by the AAP had risk factors for UTI that placed their risk for UTI above 1%. CONCLUSIONS: Our population of 2- to 12-month-old febrile infants with positive influenza/RSV testing, who did not have risk factors to make their risk of UTI higher than 1%, may not have required evaluation with urinalysis or urine culture.

AB - OBJECTIVE: Infants 12 months or younger with influenza and respiratory syncytial virus (RSV) commonly present to the emergency department (ED) with fever. Previous publications have recommended that these patients have a urinalysis and urine culture performed. We aimed to assess the prevalence of urinary tract infection (UTI) in febrile RSV/influenza positive infants aged 2 to 12 months presenting to the ED. We also examined whether the 2011 American Academy of Pediatrics (AAP) UTI clinical practice guidelines could be used to identify patients at lower risk of UTI. METHODS: This was a retrospective chart review examining all infants aged 2 to 12 months with a documented fever of higher than 38°C who presented to our ED from 2009 to 2013 and tested positive for influenza and/or RSV. RESULTS: One thousand seven hundred twenty-four patients were found to meet our inclusion criteria. Of these, 98 were excluded because of known urinary tract anomaly or systemic antibiotic use in the 24 hours preceding evaluation. Of those patients remaining, 10 (0.62%) of 1626 had positive urine cultures (95% confidence interval, 0.3%–1.1%), and 8 (0.49%) of 1626 (95% confidence interval, 0.2%–0.97%) had positive urine cultures with positive urinalyses as defined in the 2011 AAP UTI clinical practice guidelines. All subjects with positive urine cultures as defined by the AAP had risk factors for UTI that placed their risk for UTI above 1%. CONCLUSIONS: Our population of 2- to 12-month-old febrile infants with positive influenza/RSV testing, who did not have risk factors to make their risk of UTI higher than 1%, may not have required evaluation with urinalysis or urine culture.

UR - http://www.scopus.com/inward/record.url?scp=85014703662&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85014703662&partnerID=8YFLogxK

U2 - 10.1097/PEC.0000000000001073

DO - 10.1097/PEC.0000000000001073

M3 - Article

JO - Pediatric Emergency Care

JF - Pediatric Emergency Care

SN - 0749-5161

ER -