{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T06:21:39Z","timestamp":1791181299489,"version":"4.1.0"},"reference-count":27,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,2,1]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>To assess the usefulness of laboratory parameters, including peripheral white blood cell (WBC) count, C-reactive protein (CRP) concentration, erythrocyte sedimentation rate (ESR), and microscopic urinalysis (UA), for identifying febrile infants younger than 8 weeks of age at risk for urinary tract infection (UTI), and comparison of standard UA and hemocytometer WBC counts for predicting the presence of UTI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>A total of 162 febrile children &amp;lt;8 weeks of age were enrolled in this prospective study. All underwent clinical evaluation and laboratory investigation, including WBC count and differential; ESR; CRP; blood culture; a lumbar puncture for cell count and differential, glucose level, protein level, Gram stain, and culture; and a UA and urine culture. All urine specimens were obtained by suprapubic aspiration and microscopically analyzed with standard UA as well as with hemocytometer WBC counts. Quantitative urine cultures were performed. Sensitivity, specificity, accuracy, likelihood ratios, and receiver operating characteristic (ROC) curves were determined for each of the screening tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>There were 22 positive urine culture results of at least 100 colony-forming unit\/mL. Eighteen of these 22 patients were males, and all were uncircumcised. There were significant differences for pyuria \u22675 WBCs\/hpf, pyuria \u226710 WBC\/\u03bcL, CRP &amp;gt;20 mg\/L, and ESR &amp;gt;30 mm\/hour between culture-positive and culture-negative groups (P &amp;lt; .05). The ROC area for hemocytometer WBC count, standard UA, peripheral WBC count, ESR, and CRP concentration were .909 \u00b1 .045, .791 \u00b1 .065, .544 \u00b1 .074, .787 \u00b1 .060, and .822 \u00b1 .036, respectively. The ROC curve analysis indicates that the CRP, ESR, and standard UA were powerful but imperfect tools with which to discriminate for UTI in potentially infected neonates. Hemocytometer WBC counts had the highest sensitivity, specificity, accuracy, and likelihood ratios for identifying very young infants with positive urine culture results. For all assessments, hemocytometer WBC counts were significantly different, compared with the standard urinalysis. ESR, CRP, and peripheral WBC counts were not helpful in identifying UTI in febrile infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>UTI had a prevalence of 13.6% in febrile infants &amp;lt;8 weeks of age. The CRP, ESR, and standard UA were imperfect tools in discriminating for UTI, and the sensitivity of these laboratory parameters was relatively low. Hemocytometer WBC count was a significantly better predictor of UTI in febrile infants.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.105.2.e20","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:50:41Z","timestamp":1092441041000},"page":"e20-e20","source":"Crossref","is-referenced-by-count":108,"title":["Urinary Tract Infection in Febrile Infants Younger Than Eight Weeks of Age"],"prefix":"10.1542","volume":"105","author":[{"given":"Dar-Shong","family":"Lin","sequence":"first","affiliation":[{"name":"From the Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shing-Huey","family":"Huang","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, Mackay Memorial Hospital, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Chun","family":"Lin","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, Mackay Memorial Hospital, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Chen","family":"Tung","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, Mackay Memorial Hospital, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsu-Tzu","family":"Huang","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, Mackay Memorial Hospital, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan-Chang","family":"Chiu","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin-An","family":"Koa","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han-Yang","family":"Hung","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chyong-Hsin","family":"Hsu","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Shyang","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, Mackay Memorial Hospital, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dien-Ie","family":"Yang","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, Mackay Memorial Hospital, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu-Yuan","family":"Huang","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatrics and"},{"name":"Taipei Medical College, Taipei, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2000,2,1]]},"reference":[{"key":"2021121003041612200_B1","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1542\/peds.100.1.134","article-title":"Commentary on practice guidelines.","volume":"100","author":"Baraff","year":"1997","journal-title":"Pediatrics"},{"key":"2021121003041612200_B2"},{"key":"2021121003041612200_B3","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1111\/j.1464-410X.1978.tb06195.x","article-title":"The long term follow-up of surgically treated vesicoureteric reflux.","volume":"50","author":"Wallace","year":"1978","journal-title":"Br J Urol"},{"key":"2021121003041612200_B4"},{"key":"2021121003041612200_B5","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1016\/S0022-5347(17)37555-9","article-title":"Renal scarring following reflux and nonreflux pyelonephritis in children: evaluation with 99mtechnetium-dimercaptosuccinic acid scintigraphy.","volume":"147","author":"Rushton","year":"1992","journal-title":"J Urol"},{"key":"2021121003041612200_B6","first-page":"56","article-title":"Hypertension and reflux nephropathy.","volume":"13","author":"Heale","year":"1977","journal-title":"Aust Pediatr J"},{"key":"2021121003041612200_B7","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1136\/bmj.299.6701.703","article-title":"Development of hypertension and uremia after pyelonephritis in childhood: 27 year follow up.","volume":"299","author":"Jacobson","year":"1989","journal-title":"Br Med J"},{"key":"2021121003041612200_B8","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1542\/peds.59.5.663","article-title":"Temperature greater than or equal to 40\u00b0C in children less than 24 months of age: a prospective study.","volume":"59","author":"McCarthy","year":"1977","journal-title":"Pediatrics"},{"key":"2021121003041612200_B9","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1542\/peds.65.5.1036","article-title":"Early diagnosis of neonatal sepsis.","volume":"65","author":"Philip","year":"1980","journal-title":"Pediatrics"},{"key":"2021121003041612200_B10","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1111\/j.1651-2227.1979.tb08219.x","article-title":"C-reactive protein (CRP) in early diagnosis of neonatal septicemia.","volume":"68","author":"Sabel","year":"1979","journal-title":"Acta Paediatr Scand"},{"key":"2021121003041612200_B11","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1177\/000992288102000601","article-title":"Management of febrile outpatient neonates.","volume":"20","author":"Greene","year":"1981","journal-title":"Clin Pediatr"},{"key":"2021121003041612200_B12","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1177\/000992289002900803","article-title":"Febrile infants less than eight weeks old: predictors of infection.","volume":"29","author":"Broner","year":"1990","journal-title":"Clin Pediatr"},{"key":"2021121003041612200_B13","first-page":"56","article-title":"Asymptomatic infections of the urinary tract.","volume":"69","author":"Kass","year":"1956","journal-title":"Trans Assoc Am Physicians"},{"key":"2021121003041612200_B14","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1001\/archpedi.1965.02090030656007","article-title":"Pyuria and bacteruria in infants and children.","volume":"110","author":"Pryles","year":"1965","journal-title":"Am J Dis Child"},{"key":"2021121003041612200_B15","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1542\/peds.86.3.363","article-title":"Urinary tract infections in febrile infants younger than 8 weeks of age.","volume":"86","author":"Crain","year":"1990","journal-title":"Pediatrics"},{"key":"2021121003041612200_B16","first-page":"1179","article-title":"Some obervations on pyuria.","volume":"21","author":"Dukes","year":"1928","journal-title":"Proc R Soc Med"},{"key":"2021121003041612200_B17","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1136\/bmj.1.3505.391","article-title":"The examination of urine for pus.","volume":"1","author":"Dukes","year":"1928","journal-title":"Br Med J"},{"key":"2021121003041612200_B18","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/0002-9343(83)90073-6","article-title":"Measurement of pyuria and its relation to bacteriuria.","volume":"75","author":"Stamm","year":"1983","journal-title":"Am J Med"},{"key":"2021121003041612200_B19","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1542\/peds.69.4.409","article-title":"Urinary tract infections in young infants.","volume":"69","author":"Ginsburg","year":"1982","journal-title":"Pediatrics"},{"key":"2021121003041612200_B20","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1542\/peds.83.6.1011","article-title":"Risks from circumcision during the first month of life compared with those for uncircumcised boys.","volume":"83","author":"Wiswell","year":"1989","journal-title":"Pediatrics"},{"key":"2021121003041612200_B21","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1097\/00006565-199510000-00004","article-title":"Bacteremia and meningitis among infants with urinary tract infections.","volume":"11","author":"Bachur","year":"1995","journal-title":"Pediatr Emerg Care"},{"key":"2021121003041612200_B22","first-page":"889","article-title":"Bacterial and viral pathogens causing fever in infants less than three months old.","volume":"139","author":"Krober","year":"1985","journal-title":"Am J Dis Child"},{"key":"2021121003041612200_B23","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S0022-3476(05)81531-8","article-title":"Prevalence of urinary tract infection in febrile infants.","volume":"123","author":"Hoberman","year":"1993","journal-title":"J Pediatr"},{"key":"2021121003041612200_B24","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1542\/peds.91.6.1196","article-title":"Enhanced urinalysis as a screening test for urinary tract infection.","volume":"91","author":"Hoberman","year":"1993","journal-title":"Pediatrics"},{"key":"2021121003041612200_B25","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/00006454-199701000-00004","article-title":"Urinary tract infection in young febrile children.","volume":"16","author":"Hoberman","year":"1997","journal-title":"Pediatr Infect Dis J"},{"key":"2021121003041612200_B26","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/S0022-3476(05)83127-0","article-title":"Pyuria and bacteriuria in urine specimens obtained by catheter from young children with fever.","volume":"124","author":"Hoberman","year":"1994","journal-title":"J Pediatr"},{"key":"2021121003041612200_B27","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1097\/00006454-199604000-00005","article-title":"Is urine culture necessary to rule out urinary tract infection in young febrile children?","volume":"15","author":"Hoberman","year":"1996","journal-title":"Pediatr Infect Dis J"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/105\/2\/e20\/886585\/pe0200000g1p.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/105\/2\/e20\/886585\/pe0200000g1p.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T05:35:49Z","timestamp":1682746549000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/105\/2\/e20\/62580\/Urinary-Tract-Infection-in-Febrile-Infants-Younger"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,2,1]]},"references-count":27,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2000,2,1]]},"published-print":{"date-parts":[[2000,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.105.2.e20","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[2000,2,1]]}}}