Child Kidney Dis.  2015 Oct;19(2):118-124. 10.3339/chikd.2015.19.2.118.

Differentiation between Viral and Urinary Tract Infections Using the Modified Rochester Criteria In Febrile Infants Younger than three Months

• Kim TH
• Hwang JH
• Yi DY
• Yun KW
• Lim IS

• KMID: 2168411
• DOI: http://doi.org/10.3339/chikd.2015.19.2.118

Abstract

PURPOSE
The symptoms and signs of urinary tract infection (UTI) in early infancy are non-specific. Prompt diagnosis of UTI is important, as untreated UTI results in renal damage. Especially, febrile UTI in young infants coexist with other serious bacterial infections. The purpose this study was to propose modified Rochester criteria to differentiate viral infection from urinary tract infection.
METHODS
We carried out a retrospective investigation of 168 infants less than three months old with a tympanic temperature >38degrees C who were admitted to Chung-Ang University Hospital between 2011 and 2014. We compared the symptoms, physical examination results, and laboratory data between viral infection and UTI groups. A modified Rochester criterion was composed of statistically significant factors.
RESULTS
A total of 76 and 92 infants with UTI and a viral infection, respectively, were included. Statistically significant differences in gender, previous admission history, neutrophil ratio, and urine WBC count were found between the two study groups. Using a cut off value of 3 points, the sensitivity and specificity of the modified Rochester criteria were 71.28% and 78.57%, respectively.
CONCLUSION
The modified Rochester criteria may give an outline for identifying young infants with UTI.

Keyword

Young infants; Urinary tract infection; Rochester criteria

MeSH Terms

Bacterial Infections
Diagnosis
Humans
Infant*
Neutrophils
Physical Examination
Retrospective Studies
Sensitivity and Specificity
Urinary Tract Infections*
Urinary Tract*