Parameters:
(1) age in months
(2) number of risk factors for a urinary tract infection
(3) results of urinalysis (nitrite and leukocyte esterase on dipstick testing)
Risk factors for a UTI include:
(1) previous history of a urinary tract infection
(2) fever > 39°C
(3) fever without an apparent source
(4) child appears ill
(5) suprapubic tenderness
(6) fever lasting > 24 hours
(7) nonblack race
|
Age in Months
|
Number of Risk Factors
|
Urinalysis
|
Probability of UTI
|
|
3 - 11
|
0
|
NA
|
< 2%
|
|
3 - 11
|
>=1
|
neither positive
|
2 - 6%
|
|
3 - 11
|
>=1
|
one positive
|
40 - 66%
|
|
3 - 11
|
>=1
|
both positive
|
75 to 90%
|
|
12 - 24
|
0
|
NA
|
< 2%
|
|
12 - 24
|
>=1
|
neither positive
|
< 2%
|
|
12 - 24
|
>=1
|
one positive
|
15 - 34%
|
|
12 - 24
|
>=1
|
both positive
|
46 - 71%
|
where:
• As written any white or Hispanic female 3 to 11 months needs to have a urinalysis done.
• The probabilities given for females are the same as for males in each group, which seems somewhat surprising.
A child with no risk factors should be re-evaluated at 24 hours to look for any evidence of a UTI (persistent fever might be enough to do additional testing).
A child who is at increased risk may need to be catheterized to obtain a valid specimen. A urine culture should be performed on the collected specimen so care should be taken in its collection.
