The age-related risk of co-existing meningitis in children with urinary tract infection

Tebruegge, Marc, Pantazidou, Anastasia, Clifford, Vanessa, Gonis, Gena, Ritz, Nicole, Connell, Tom and Curtis, Nigel (2011) The age-related risk of co-existing meningitis in children with urinary tract infection PLoS ONE, 6, (11), e26576. (doi:10.1371/journal.pone.0026576). (PMID:22096488).


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Objective: The primary aim of this study was to determine age-stratified rates of co-existing bacterial meningitis in children with urinary tract infection (UTI). The secondary aims of this study were to determine the causative pathogens of UTI, and the clinical features and outcome of children with co-existing meningitis.

Methods: Analysis of data collected over a nine-year period at a tertiary pediatric hospital in Australia. Study population: children below 16 years of age with culture-confirmed UTI and a paired CSF sample.

Results: A total of 748 episodes in 735 cases were included in the final analysis. The commonest pathogens causing UTI were Escherichia coli (67.4%), Enterococcus faecalis (8.4%), Klebsiella oxytoca (3.5%) and Klebsiella pneumoniae (3.5%). Only two (1.2%; 95% CI: 0.15–4.36%) of 163 neonates (between 0 and 28 days of age) with UTI had co-existing meningitis. Both presented with pyrexia, irritability and lethargy, and recovered uneventfully with antibiotic treatment. There were no cases of co-existing meningitis among 499 infants (between 29 days and 12 months of age) with UTI (95% CI: 0.00–0.74%), or any of the 86 children aged 12 months or over (95% CI: 0.00–4.20%).

Conclusions: These findings indicate that clinicians should have a low threshold to perform a lumbar puncture in neonates with UTI, as the risk of co-existing meningitis is not insignificant in this age group. In contrast, beyond the neonatal period, the risk is small and a more selective approach is warranted.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1371/journal.pone.0026576
ISSNs: 1932-6203 (print)
Keywords: infectious diseases, microbiology, neurological disorders, pediatrics and child health, public health and epidemiology

Organisations: Faculty of Medicine
ePrint ID: 337532
Date :
Date Event
9 November 2011Published
Date Deposited: 26 Apr 2012 15:34
Last Modified: 17 Apr 2017 17:15
Further Information:Google Scholar

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