• Marsha A Elkhunovich, Vincent J Wang, Phung Pham, Joyce C Arpilleda, Joel M Clingenpeel, Karim Mansour, Teresa Riech, Ken Yen, and Deborah R Liu.
• From the Division of Emergency Medicine, Children's Hospital Los Angeles, Los Angeles, CA.
• Pediatr Emerg Care. 2021 Dec 1; 37 (12): e1104e1109e1104-e1109.

BackgroundThe utility of testing for urinary tract infection (UTI) in febrile infants with bronchiolitis is indeterminate.ObjectiveThe objective of this study was to investigate if the incidence of UTIs in febrile infants 2 to 12 months of age with bronchiolitis is higher than the presumed incidence of asymptomatic bacteriuria and determine risk factors associated with UTIs in this population.MethodsThis prospective multicenter cross-sectional study was conducted in the emergency departments of 6 children's hospitals between November 2011 and June 2015. We obtained a convenience sample of febrile infants with bronchiolitis 2 to 12 months of age who were tested for UTI. Patient characteristics analyzed included age, maximum temperature, duration of fever, ethnicity, sex, and circumcision status.ResultsA total of 442 patients (including 86 from a previously published pilot study) were enrolled. Mean age was 5.5 months, 65.2% were Latino, 50.9% were male, and 27.6% of male infants were circumcised. Urinary tract infections were found in 33 patients (7.69%, binomial; 95% confidence interval [CI], 5.19%-10.33%). Urinary tract infections were not related to age, height of temperature, duration of fever, or ethnicity. Uncircumcised males were significantly more likely to have UTIs than circumcised males (7.64% vs 0%, P = 0.03). Odds ratios (ORs) were lower for circumcised males but not uncircumcised males when compared with females (OR, 0.12; CI, 0.0-0.71; P = 0.01 vs OR, 0.77; CI, 0.33-1.74; P = 0.64).ConclusionsFebrile infants 2 to 12 months of age with bronchiolitis have a clinically significant incidence of UTI, suggesting that UTI evaluation should be considered in these patients.Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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