Orli Megged1. 1. Pediatric Department and Infectious Diseases Unit, Shaare Zedek Medical Center affiliated with Hebrew University-Hadassah School of Medicine, Jerusalem, Israel. Electronic address: orlimegged@yahoo.com.
Abstract
AIM: Bacteremia is an uncommon complication of urinary tract infection (UTI). The aim of this study was to identify risk factors for bacteremic UTI in pediatric patients. METHODS: The medical records of all pediatric patients with UTI between 2013 and 2014 were retrospectively reviewed. Pediatric patients with accompanying bacteremia were compared with pediatric patients with no bacteremia. RESULTS: Five hundred twenty-seven cases of UTI were identified. Blood cultures were taken in 464, 26 (5.6%) of which also were bacteremic. Pediatric patients with bacteremia were more likely to be male (58% vs 28%, P<.01), to be younger than 3 months (54% vs 31%, P=.02), and to have higher creatinine (average 0.77±0.97 vs 0.34±0.24, P<.01). Pediatric patients with bacteremia had higher rate of underlying urologic conditions. The following variables were included in multivariate analysis: age <3months, sex, ethnicity, method of urine collection, creatinine, and underlying urologic conditions. Only creatinine (odds ratio, 3.67; 95% confidence interval, 1.69-8.11) was found as an independent risk factor for bacteremia. CONCLUSIONS: High creatinine at presentation is a risk factor that might aid in early identification of pediatric patients with high risk for bacteremia and its complications.
AIM: Bacteremia is an uncommon complication of urinary tract infection (UTI). The aim of this study was to identify risk factors for bacteremic UTI in pediatric patients. METHODS: The medical records of all pediatric patients with UTI between 2013 and 2014 were retrospectively reviewed. Pediatric patients with accompanying bacteremia were compared with pediatric patients with no bacteremia. RESULTS: Five hundred twenty-seven cases of UTI were identified. Blood cultures were taken in 464, 26 (5.6%) of which also were bacteremic. Pediatric patients with bacteremia were more likely to be male (58% vs 28%, P<.01), to be younger than 3 months (54% vs 31%, P=.02), and to have higher creatinine (average 0.77±0.97 vs 0.34±0.24, P<.01). Pediatric patients with bacteremia had higher rate of underlying urologic conditions. The following variables were included in multivariate analysis: age <3months, sex, ethnicity, method of urine collection, creatinine, and underlying urologic conditions. Only creatinine (odds ratio, 3.67; 95% confidence interval, 1.69-8.11) was found as an independent risk factor for bacteremia. CONCLUSIONS: High creatinine at presentation is a risk factor that might aid in early identification of pediatric patients with high risk for bacteremia and its complications.