Routine Urine Culture in Febrile Young Children

Objective: To assess the usefulness of the routine urine culture in febrile young children. setting: Tertiary care teaching hospital design: One year’s prospective study from October 2009 to September 2010 Patients: 334 febrile young children who were less than 5 years of age, who were admitted to the paediatric ward. Results: Out of 334 febrile children, 27 cases were diagnosed to have UTI , with overall estimated prevalence of 8.08%. Of the 27 patients with UTI, 17 (62.96%) cases had a provisional diagnosis which was other than UTI. One or the other symptoms which were referable to the urinary tract were present only in 52% of the patients with UTI. In 24% of the children with UTI, no other sign which was referable to the urinary tract was present, other than fever. A low yield was obtained in patients with respiratory infection (2.18%), neuroinfection (3.70%) and with enteric fever (3.84%). Of the 52 patients with gastroenteritis (GE), 5(9.61%) cases had UTI. Female patients with GE are particularly at an increased risk of UTI (23.52%). A high yield was obtained in patients with a provisional diagnosis of UTI (47.61%). Out of 31 patients who presented with fever with no apparent source, 7(22.58%) cases showed a significant growth on urine culture. Conclusion: Urinary tract infection should be considered as a potential cause of fever in children below 5 years of age. A high yield was obtained whenever UTI was suspected, or in patients with fever with no apparent source and in female children with gastroenteritis. Routine Urine Culture in Febrile Young Children key Words: Febrile, urine culture, urinary tract infection, young children original article developing countries. With a view on the above concerns, this study was under taken. METHODs Inclusion Criteria: Febrile children who were less than 5 years of age, who were admitted to the paediatric ward with an axillary temperature of ≥ 37.4oC within 24 hours of admission, were included in the study. Exclusion Criteria: Those children who had received antibiotics or had undergone bladder catheterization within 48 hours prior to the admission were excluded. A detailed history was taken and clinical examination was done in all the cases to find out the cause of the fever, with special emphasis being given to the symptoms of UTI. Necessary investigations were carried out to find the cause of the fever. The perineum and the genitalia were washed with soap and water. A freshly voided, clean catch, mid stream urine sample was collected in sterile containers for urinalysis and culture. The urine was collected by catheterization in those children who could not void urine within 24 hours after admission, after taking aseptic p ed ia tr ic s s ec tio n