TY - JOUR
T1 - Assessing the utility of urine testing in febrile infants 2 to 12 months of age with bronchiolitis
AU - Elkhunovich, Marsha A.
AU - Wang, Vincent J.
AU - Pham, Phung
AU - Arpilleda, Joyce C.
AU - Clingenpeel, Joel M.
AU - Mansour, Karim
AU - Riech, Teresa
AU - Yen, Ken
AU - Liu, Deborah R.
N1 - Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Background: The utility of testing for urinary tract infection (UTI) in febrile infants with bronchiolitis is indeterminate. Objective: The objective of this study was to investigate if the incidence of UTIs in febrile infants 2 to 12 months of age with bronchiolitis is higher than the presumed incidence of asymptomatic bacteriuria and determine risk factors associated with UTIs in this population. Methods: This prospective multicenter cross-sectional study was conducted in the emergency departments of 6 children's hospitals between November 2011 and June 2015. We obtained a convenience sample of febrile infants with bronchiolitis 2 to 12 months of age who were tested for UTI. Patient characteristics analyzed included age, maximum temperature, duration of fever, ethnicity, sex, and circumcision status. Results: A total of 442 patients (including 86 froma previously published pilot study) were enrolled. Mean age was 5.5 months, 65.2% were Latino, 50.9% were male, and 27.6% of male infants were circumcised. Urinary tract infections were found in 33 patients (7.69%, binomial; 95% confidence interval [CI], 5.19%-10.33%). Urinary tract infections were not related to age, height of temperature, duration of fever, or ethnicity. Uncircumcised males were significantly more likely to have UTIs than circumcised males (7.64% vs 0%, P = 0.03). Odds ratios (ORs) were lower for circumcised males but not uncircumcised males when compared with females (OR, 0.12; CI, 0.0-0.71; P = 0.01 vs OR, 0.77; CI, 0.33-1.74; P = 0.64). Conclusions: Febrile infants 2 to 12 months of age with bronchiolitis have a clinically significant incidence of UTI, suggesting that UTI evaluation should be considered in these patients.
AB - Background: The utility of testing for urinary tract infection (UTI) in febrile infants with bronchiolitis is indeterminate. Objective: The objective of this study was to investigate if the incidence of UTIs in febrile infants 2 to 12 months of age with bronchiolitis is higher than the presumed incidence of asymptomatic bacteriuria and determine risk factors associated with UTIs in this population. Methods: This prospective multicenter cross-sectional study was conducted in the emergency departments of 6 children's hospitals between November 2011 and June 2015. We obtained a convenience sample of febrile infants with bronchiolitis 2 to 12 months of age who were tested for UTI. Patient characteristics analyzed included age, maximum temperature, duration of fever, ethnicity, sex, and circumcision status. Results: A total of 442 patients (including 86 froma previously published pilot study) were enrolled. Mean age was 5.5 months, 65.2% were Latino, 50.9% were male, and 27.6% of male infants were circumcised. Urinary tract infections were found in 33 patients (7.69%, binomial; 95% confidence interval [CI], 5.19%-10.33%). Urinary tract infections were not related to age, height of temperature, duration of fever, or ethnicity. Uncircumcised males were significantly more likely to have UTIs than circumcised males (7.64% vs 0%, P = 0.03). Odds ratios (ORs) were lower for circumcised males but not uncircumcised males when compared with females (OR, 0.12; CI, 0.0-0.71; P = 0.01 vs OR, 0.77; CI, 0.33-1.74; P = 0.64). Conclusions: Febrile infants 2 to 12 months of age with bronchiolitis have a clinically significant incidence of UTI, suggesting that UTI evaluation should be considered in these patients.
KW - Bronchiolitis
KW - Fever
KW - Urinary tract infection
UR - http://www.scopus.com/inward/record.url?scp=85090344941&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85090344941&partnerID=8YFLogxK
U2 - 10.1097/PEC.0000000000001912
DO - 10.1097/PEC.0000000000001912
M3 - Article
C2 - 31804430
AN - SCOPUS:85090344941
SN - 0749-5161
VL - 37
SP - E1104-E1109
JO - Pediatric emergency care
JF - Pediatric emergency care
IS - 12
ER -