68 / 330
68
28
TH
CONGRESS OF THE ESPU
09:38–09:41
S6-3 (PP)
PREDICTORS OF URINARY TRACT INFECTION IN YOUNG
FEBRILE CHILDREN
Dinesh DHAREL
1
, Srijana BASNET
2
, Bharatmani POKHAREL
3
, Asmita BHATTARAI
1
and Fakir Chandra GAMI
4
1) BP Koirala Institute of Health Sciences, Pediatrics, Dharan, NEPAL - 2) Institute of Medicine, TU Teaching Hospital,
Pediatrics, Kathmandu, NEPAL - 3) Institute of Medicine, Tribhuvan University, Microbiology, Kathmandu, NEPAL -
4) Institute of Medicine, Tribhuvan University, Pediatrics, Kathmandu, NEPAL
PURPOSE
This study was undertaken to identify whether any clinical features and urinalysis findings help to
predict urinary tract infection in young febrile children.
MATERIAL AND METHODS
This prospective observational study was conducted over seven month’s period at Pediatric
Department of a University Teaching Hospital, among children aged 3 to 36 months, presenting
with fever without a definite focus. Clinical features and urinalysis were compared with positive urine
culture to calculate the sensitivity, specificity, predictive values and likelihood ratios. The independ-
ent predictors of UTI were identified using binary logistic regression.
RESULTS
Out of 248 children, 26 (10.5%) had culture positive UTI; Escherichia coli (80.8%) being the com-
monest organism. Fever for more than three days, high grade fever ≥102 degF, history of recurrent
fever of uncertain origin, urinary symptoms, past history of UTI, phimosis, renal angle tenderness,
pain abdomen, failure to gain weight, constipation and pyuria were significantly associated with
UTI, with variable sensitivity (15.4-80.8%), specificity (45.1-99.5%), positive predictive values (14.7-
87.5%) but good negative predictive values (90.6-95.2%). The positive likelihood ratio was strong
for past history of UTI (25.62), renal angle tenderness (59.77), phimosis (19.92) and pyuria (9.07).
History of recurrent fever of uncertain origin, presence of phimosis and pyuria were independent
predictors of UTI in febrile young children.
CONCLUSIONS
Certain clinical features and pyuria may predict UTI in young febrile children without definite focus,
thus helping clinicians to initiate antibiotics pending results of urine culture.
09:41–09:53
Discussion