Monitoring Health Care: Children with Bacteriuria

A program which used a nurse clinician to monitor the health care received by children with bacteriuria is described. We identified 152 patients with significant bacteriuria (≥ 105 organisms/ml) by urine culture from 351 patients who either had symptoms suggestive of urinary tract infections or routine urinalysis during health care visits. Adequate health care was provided to 116 (76 per cent) of the 152 patients and inadequate health care to 31 (24 per cent) of these patients. A significant number of patients who received inadequate therapy (12 of 36, or 37 per cent) compared to 8 (7 per cent) of 116 patients who received adequate therapy failed to clear their bacteriuria (Chi-square = 17, p < 0.001). Eight patients with recurrent bacteriuria despite adequate therapy were shown to have no urinary tract anomaly by radiography. The use of recurrence of UTI as a criterion for measuring adequacy of therapy and the uniqueness of the program are discussed.