Pneumococcosuria in children.

Streptococcus pneumoniae was present, in pure or mixed culture, in 43 (0.08%) of 53,499 urine cultures submitted from a pediatric population over a 4-year period. Data were analyzed from 28 children, from whom 78% of these positive cultures originated. Ninety-six percent of the children were female, and the median age was 3 years (range, 0.4 to 17 years). Only five children had S. pneumoniae as the sole organism cultured from the urine, and all five had only a single urine culture. Urine from the other 23 children contained other organisms as well. Small numbers of pneumococci were found in most urines: 74% contained less than 10(4) CFU/ml and 93% contained less than 10(5) CFU/ml. There was no association between genitourinary symptoms and pneumococcosuria, and complete resolution of symptoms occurred in both treated and untreated children. Pneumococcosuria could not be explained by pneumococcal bacteremia. We conclude that pediatric pneumococcosuria is not associated with urinary tract infections in children, or with pneumococcal bacteremia or invasive disease elsewhere. Pneumococcosuria probably reflects contamination of urine specimens with S. pneumoniae from perineal colonization.