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G467(P) Diagnosis of urinary tract infection in infants under 1 year of age
  1. L Mulligan,
  2. L McLaren,
  3. A McKie
  1. General Paediatrics Royal Alexandra Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK

Abstract

Aims To identify:

1. The most common presenting complaints of infants that have urine samples sent for microscopy and culture

2. If dipstick analysis is a reliable investigation in diagnosing urinary tract infection in infants under the age of 1

3. If urine microscopy is a reliable investigation in diagnosing urinary tract infection in infants under the age of 1

Method Retrospective case note review of all patients under the age of 1 with urine samples sent for culture from Children’s ward in RAH between January and March 2016.

Results

  • 98 samples included in study.

  • 84 patients (49 male, 35 female).

  • 26 infants (31%) had full septic screen and commenced on IV antibiotics as per local guidelines.

  • 94 samples obtained by clean catch urine, 1 sample from in- and-out catheter and 1 suprapubic aspiration.

  • 48% of patients presented with pyrexia and 18% with vomiting.

  • 33 patients had no documented urinalysis, 5 samples were positive.

  • 12 samples were positive for leucocytes +/ nitrites, 33% had a positive culture.

Conclusions

  • Most common presenting complaint in infants that have a urine sample sent is temperature.

  • Difficult to compare data due to differences in numbers of negative and positive results.

  • Dipstick analysis is not a sensitive measure of infection in this age group.

  • The majority of negative cultures will have either ‘scanty or nil’ organisms on microscopy.

  • 58% of positive cultures have ‘scanty’ cell counts likely to get false negatives.

  • A sample with numerous cells and numerous organisms is likely to be a positive UTI.

  • The majority (76%) of negative cultures have scanty or nil on cell count.

Recommendations

  1. Better documentation of urinalysis results on the ward.

  2. Further data needs to be analysed as small sample included in this study.

  3. Further audit after feedback to ward staff to identify improvement in urinalysis documentation.

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