Prevalence of bacteriuria in febrile infants

Urine samples from 129 admitted febrile infants were collected using the suprapubic aspiration technique, and subjected to routine urinalysis, culture, and antibiotic sensitivity testing. Most of the infants suffered from respiratory tract infections (n = 80) and gastroenteritis (n = 25). Sixty nine patients were male and sixty female. In all, 7 patients had positive cultures (5.4%), indicating a high yield (> 5%). Six of these were female and occurred in patients with gastroenteritis (p < 0.05 for both by chi 2 and Z test). Four patients showed pus cells and organisms on smear, and all of them were culture positive. Another three had only pus cells, but were also culture positive. One patient each, who had pus cells only or organisms only on smear had no growth on culture. E. coli was grown in 6 of these cases, and Klebsiella in one. All cultures were sensitive to ciprofloxacin. Variable sensitivity was seen with gentamicin, streptomycin, and furadantin. The organisms were uniformly resistant to ampicillin and chloramphenicol. The procedure of suprapubic aspiration was safe with no complications. Our findings indicate that bacteriuria is not uncommon in febrile infants even with clinical evidence of other illnesses and that female children, especially those with gastroenteritis, are at most risk. Routine urine cultures in such patients would appear justified.