Shaikh et al developed the UTICalc for estimating the probability of a urinary tract infection (UTI) in a young febrile child. This can help to determine if ordering a urine culture is appropriate. The authors are from the Children's Hospital of Pittsburgh and the University of Pittsburgh.
Patient selection: child from 2 months to less than 2 years old with temperature >= 38°C and no urinary tract abnormalities
Parameters:
(1) age in months
(2) race Black
(3) other source of fever (other than urinary tract)
(4) maximum temperature >= 39°C
(5) female, uncircumcised male or circumcised male
For a female or uncircumcised male
|
Age in Months |
Race Black |
Other Source |
Max Temp >= 39°C |
Percent with UTI |
|
< 12 |
N |
N |
Y |
25.1 |
|
< 12 |
N |
N |
N |
12.3 |
|
< 12 |
N |
Y |
Y |
7.56 |
|
< 12 |
N |
Y |
N |
3.35 |
|
< 12 |
Y |
N |
Y |
11.3 |
|
< 12 |
Y |
N |
N |
5.06 |
|
< 12 |
Y |
Y |
Y |
3.07 |
|
< 12 |
Y |
Y |
N |
1.3 |
|
>= 12 |
N |
N |
Y |
9.53 |
|
>= 12 |
N |
N |
N |
4.21 |
|
>= 12 |
N |
Y |
Y |
2.55 |
|
>= 12 |
N |
Y |
N |
1.08 |
|
>= 12 |
Y |
N |
Y |
3.86 |
|
>= 12 |
Y |
N |
N |
1.65 |
|
>= 12 |
Y |
Y |
Y |
0.99 |
|
>= 12 |
Y |
Y |
N |
0.41 |
A urine culture was performed if the risk of UTI was high. This was assigned to a patient with percent UTI >= 2.0%.
For a circumcised male
|
Age in Months |
Race Black |
Other Source |
Max Temp >= 39°C |
Likelihood Ratio |
|
< 12 |
N |
N |
Y |
0.32 (*) |
|
< 12 |
N |
N |
N |
0.14 |
|
< 12 |
N |
Y |
Y |
0.05 |
|
< 12 |
N |
Y |
N |
0.04 |
|
< 12 |
Y |
N |
Y |
0.13 |
|
< 12 |
Y |
N |
N |
0.12 |
|
< 12 |
Y |
Y |
Y |
0.24 |
|
< 12 |
Y |
Y |
N |
0 |
|
>= 12 |
N |
N |
Y |
0.36 |
|
>= 12 |
N |
N |
N |
0.5 |
|
>= 12 |
N |
Y |
Y |
0 |
|
>= 12 |
N |
Y |
N |
0 |
|
>= 12 |
Y |
N |
Y |
0 |
|
>= 12 |
Y |
N |
N |
0 |
|
>= 12 |
Y |
Y |
Y |
0 |
|
>= 12 |
Y |
Y |
N |
0 |
Most combinations indicate a low risk of UTI. The only combination with >= 2% is marked by the asterisk.
Specialty: Infectious Diseases, Pedatrics, Urology
