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The incidence of symptomatic Urinary Tract Infection (U.T.I.) in 2980 children aged under 2 years was valued. The study was performed in the Pediatric Clinic of Palermo between January 1988 and December 1989 involving a number of out paediatricians. The U.T.I. incidence was found to be 3.38%, with a higher frequency in males (4.7%) than in females (2.03%). Urinary tract malformations was diagnosed in 60% of patients with U.T.I. echographically and radiographically examined.

We have retrospectively studied 101 patients with an age below 24 months consecutively hospitalized, for symptomatic urinary tract infections, in the "Ospedale dei Bambini" of Palermo and subjected to radiological studies (urography and voiding cystouretrography). We have considered if the symptoms and the clinical objectivity could have given useful indications in the choice of the patients to be subjected to radiological studies. The clinical-anamnestic data have not allowed to distinguish, among patients with U.T.I., between the individuals with an abnormal conformation those with a normal one; however they have allowed to focus our attention on patients with U.T.I. through the singling out of some symptoms such as fever, vomit, cyanosis and anomaly micturition. Another datum standing out from our study is that the beginning of the symptoms in patients with U.T.I. was more precocious if at their basis there was urinary malformation.

Bacteria counts in fresh, unstained, uncentrifuged urine specimens, using a phase-contrast microscope, magnification X 400, and a hemocytometer chamber, proved to be a very useful method not only of excluding (specificity 0.92) but also identifying urinary tract infection (sensitivity 0.90) in children. The presence of greater than 5/0.1 ml bacteria in the urine was taken as the threshold value. The evaluation of leukocyturia alone did not alter the sensitivity of the method, even when it was associated with bacteriuria. When Proteus was isolated from urine cultures, the bacteria count proved negative in 60% of cases; otherwise when different bacteria were isolated in urine cultures, they were then identified during the bacteria count. The method is simple, inexpensive and rapid (it requires only a few minutes) and it may be used in a pediatric outpatient or hospital setting.