PT - JOURNAL ARTICLE AU - Aisling Rafferty AU - Richard J Drew AU - Robert Cunney AU - Désirée Bennett AU - John Francis Marriott TI - Infant <em>Escherichia coli</em> urinary tract infection: is it associated with meningitis? AID - 10.1136/archdischild-2021-322090 DP - 2022 Mar 01 TA - Archives of Disease in Childhood PG - 277--281 VI - 107 IP - 3 4099 - http://adc.bmj.com/content/107/3/277.short 4100 - http://adc.bmj.com/content/107/3/277.full SO - Arch Dis Child2022 Mar 01; 107 AB - Objectives Determine the prevalence of coexisting bacterial meningitis (BM) and sterile cerebrospinal fluid (CSF) with raised white cell count relative to age (‘pleocytosis’) in the presence of Escherichia coli urinary tract infection (UTI), with the addition of CSF E. coli PCR analysis.Design Single-centre, retrospective cohort study.Setting Tertiary paediatric hospital.Participants Children aged 8 days to 2 years, with a pure growth of E. coli from urine and a CSF sample taken within 48 hours of a positive urine culture between 1 January 2014 and 30 April 2019.Main outcome measure Prevalence of coexisting E. coli BM with UTI, defined as a pure growth E. coli from urine and a CSF culture with pure growth E. coli and/or positive E. coli PCR.Results 1903 patients had an E. coli UTI, of which 314 (16%) had a CSF sample taken within 48 hours. No cases of coexisting E. coli BM were identified. There were 71 (23%) cases of pleocytosis, 57 (80%) of these had PCR analysis, all of which were E. coli PCR not detected. Patients aged 1–6 months accounted for 72% of all lumbar punctures (LPs).Conclusion The risk of E. coli UTI and coexisting E. coli BM is low. There is potential to reduce the number of routine LPs in infants with a diagnosis of E. coli UTI with the greatest impact in children up to 6 months of age. CSF E. coli PCR can help further reduce post-test probability of BM in the setting of pleocytosis.Data are available on reasonable request. Data are available on reasonable request from rafferty.aisling@gmail.com.