Urinary Tract Infection

2mo – 18 years

• Recurrent UTI

• Chronic Kidney Disease

• GU Abnormality

• Sepsis / Meningitis / ICU Status

• Immunocompromised

• Pregnant

• Catheterized routine UA and Ucx

Do NOT send any bag specimen for urine culture

Any positive bag UA MUST be confirmed with cath specimen

• Midstream clean catch

Do NOT send any bag specimen for urine culture

Any positive bag UA MUST be confirmed with cath specimen

Consider UTI Workup In:

Girls with more than one of following:

• Age < 12 mos

• Temp ≥39°C

• Fever for ≥ 2 days

• Absence of other source

Boys who are:

• Uncircumcised AND < 2 yo

• Temp ≥ 39°C, fever for 24+ hours, AND absence of other source

UA positive if:

• > 5 WBC per HPF

• Positive LE and/or positive nitrates

UTI confirmed if UA AND Ucx positive as below:

UA Results

• > 5 WBC per HPF

• Positive LE and/or positive nitrates

Ucx Results

Culture positive for UTI and growing:

• 100,000 CFU (clean catch)

• 50,000 CFU (cath)

• Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management, Roberts KB. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics 2011; 128:595.

• Gorelick. MH, Shaw KN. Clinical decision rule to identify febrile young girls at risk for urinary tract infection. Arch Pediatr Adolesc Med. 2000;154(4): 386-390

• Shaikh N, Morone NE, Lopez J, et al. Does this child have a urinary tract infection? JAMA. 2007; 298 (24): 2895-2904. Oreskovic NM, Sembrano EU. Repeat Urine cultures in children who are admitted with urinary tract infections. Pediatrics; 2007; 119(2):e325-9.

Revision date: November 2017
Approval date: November 2017
Next revision date: October 2019