{"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":1791181299892,"version":"4.1.0"},"reference-count":27,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,12,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>There is limited evidence from which to derive guidelines for the management of febrile infants aged 29 to 60 days with urinary tract infections (UTIs). Most such infants are hospitalized for \u226548 hours. Our objective was to derive clinical prediction models to identify febrile infants with UTIs at very low risk of adverse events and bacteremia in a large sample of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>This study was a 20-center retrospective review of infants aged 29 to 60 days with temperatures of \u226538\u00b0C and culture-proven UTIs. We defined UTI by growth of \u226550 000 colony-forming units (CFU)\/mL of a single pathogen or \u226510 000 CFU\/mL in association with positive urinalyses. We defined adverse events as death, shock, bacterial meningitis, ICU admission need for ventilator support, or other substantial complications. We performed binary recursive partitioning analyses to derive prediction models.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>We analyzed 1895 patients. Adverse events occurred in 51 of 1842 (2.8% [95% confidence interval (CI): 2.1%\u20133.6%)] and bacteremia in 123 of 1877 (6.5% [95% CI: 5.5%\u20137.7%]). Patients were at very low risk for adverse events if not clinically ill on emergency department (ED) examination and did not have a high-risk past medical history (prediction model sensitivity: 98.0% [95% CI: 88.2%\u201399.9%]). Patients were at lower risk for bacteremia if they were not clinically ill on ED examination, did not have a high-risk past medical history, had a peripheral band count of &amp;lt;1250 cells per \u03bcL, and had a peripheral absolute neutrophil count of \u22651500 cells per \u03bcL (sensitivity 77.2% [95% CI: 68.6%\u201384.1%]).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION:<\/jats:title><jats:p>Brief hospitalization or outpatient management with close follow-up may be considered for infants with UTIs at very low risk of adverse events.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2010-0479","type":"journal-article","created":{"date-parts":[[2010,11,23]],"date-time":"2010-11-23T04:48:04Z","timestamp":1290487684000},"page":"1074-1083","source":"Crossref","is-referenced-by-count":116,"title":["Febrile Infants With Urinary Tract Infections at Very Low Risk for Adverse Events and Bacteremia"],"prefix":"10.1542","volume":"126","author":[{"given":"David","family":"Schnadower","sequence":"first","affiliation":[{"name":"Pediatric Emergency Medicine, Morgan Stanley Children's Hospital of New York, Columbia University College of Physicians and Surgeons, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Kuppermann","sequence":"additional","affiliation":[{"name":"Emergency Medicine and Pediatrics, University of California, Davis School of Medicine, Sacramento, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles G.","family":"Macias","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen B.","family":"Freedman","sequence":"additional","affiliation":[{"name":"Paediatric Emergency Medicine and Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc N.","family":"Baskin","sequence":"additional","affiliation":[{"name":"Pediatrics, Children's Hospital Boston and Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Ishimine","sequence":"additional","affiliation":[{"name":"Department of Medicine, Rady Children's Hospital, University of California, San Diego, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Scribner","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine, Children's Hospital Oakland, Oakland, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Okada","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine, Children's Medical Center, University of Texas 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Medical College of Wisconsin, Milwaukee, Wisconsin;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna M.","family":"Sutherland","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine, Wake Med Health, Raleigh, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes M.","family":"Blackstone","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Sarnaik","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine, Children's Hospital of Michigan, Wayne State University, Detroit, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"McManemy","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine, St Louis Children's Hospital, Washington University School of Medicine, St Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Brent","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine, Children's Hospital, University of Colorado School of Medicine, Denver, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Bennett","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Medicine, A. 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