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Predictive factors for bacteremia in febrile infants with urinary tract infection

 Seo Hee Yoon  ;  HyunDo Shin  ;  Keum Hwa Lee  ;  Moon Kyu Kim  ;  Dong Soo Kim  ;  Jong Gyun Ahn  ;  Jae Il Shin 
 SCIENTIFIC REPORTS, Vol.10(1) : e4469, 2020 
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This study aimed to investigate the predictive factors of concomitant bacteremia occurring in febrile infants who initially presented with pyuria and fever, and were subsequently diagnosed with culture-proven urinary tract infection (UTI). We conducted a retrospective cohort study for January 2010-October 2018 that included infants younger than six months with febrile UTI at a tertiary hospital. The study included 463 patients, of whom 34 had a concomitant bacteremic UTI. Compared to those in the non-bacteremic urinary tract infection (UTI) group, the bacteremic UTI group had a lower mean age; higher levels of C-reactive protein (CRP), delta neutrophil index (DNI, reflects the fraction of immature granulocytes) and blood urea nitrogen (BUN); lower levels of hemoglobin (Hb) and albumin; and a lower platelet count. Vesicoureteral reflux (VUR) was detected nearly twice as often in patients with bacteremic UTI compared to those with non-bacteremic UTI (59.3% vs. 30.6%; P = 0.003). Univariate logistic analyses showed that age ≤90 days; higher DNI, CRP, and creatinine levels; lower Hb and albumin levels; and the presence of VUR were predictors for bacteremic UTI. On multivariate logistic regression analysis, age ≤90 days, higher DNI and CRP levels, and the presence of VUR were independent predictors of bacteremic UTI. The area under the receiver operating characteristic curve of the multivariate model was 0.859 (95% CI, 0.779-0.939; P < 0.001). Age ≤90 days, higher DNI and CRP values may help predict bacteremia of febrile infants younger than 6 months with UTI. Vesicoureteral reflux imaging is also recommended in infants with bacteremic UTI to evaluate VUR.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Soo(김동수)
Kim, Moon Kyu(김문규) ORCID logo https://orcid.org/0000-0001-6186-3991
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
Ahn, Jong Gyun(안종균) ORCID logo https://orcid.org/0000-0001-5748-0015
Yoon, Seo Hee(윤서희) ORCID logo https://orcid.org/0000-0002-8361-9815
Lee, Keum Hwa(이금화) ORCID logo https://orcid.org/0000-0002-1511-9587
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