Leukocyte Counts in Urine and Sepsis Risk in Infants
Author Information
Author(s): Bonsu Bema K, Harper Marvin B
Primary Institution: Children's Hospital Boston
Hypothesis
There is an association between the concentration of leukocytes in urine and the risk of bacteriuric sepsis in febrile young infants.
Conclusion
Leukocytes in urine can indicate the likelihood of bacteriuric sepsis in young infants, with low leukocyte counts reflecting a low risk of invasive bacterial infections.
Supporting Evidence
- Infants with urinary leukocytes < 10 cells/hpf had a 0% rate of concomitant bacterial infections.
- The accuracy of urine leukocytes for predicting bacteriuric sepsis was high, with an AUC of 0.94.
- The study included 3765 febrile infants, with 307 having positive urine cultures.
Takeaway
If a baby has a urine test with very few white blood cells, they are less likely to have a serious infection, even if they have a fever.
Methodology
Retrospective cohort study of febrile infants aged 0-89 days evaluated for sepsis, comparing urine leukocyte counts and rates of bacteriuric sepsis.
Potential Biases
Potential for selection bias due to the retrospective nature and reliance on historical data.
Limitations
The study is retrospective, which limits the ability to establish causation and assess pre-treatment with antibiotics.
Participant Demographics
Infants aged 0-89 days, with a diverse racial background: 35% Caucasian, 25% African American, 20% Hispanic, and 20% other.
Statistical Information
P-Value
0
Confidence Interval
0–0.3%
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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