Search

Eight hundred healthy female infants presenting for routine care were systematically screened for bacteriuria from early infancy to 2 years of age. The initial urinary tract infection was established in 29 infants, 3.6% of the series, at a median age of 9 months. Continued systematic screening of 25 of these 29 infants with bacteriuria to 6 years of age revealed recurrent infection in nine of them and the development of pyelonephritis in three. Recurrent episodes of infection occurred at close intervals of 2 weeks to 4 months in these nine infants and were clustered within an 18-month period. There were no recurrences after 3 years of age. Characteristically, both the initial and recurrent infections were asymptomatic. Lower urinary tract signs of infection, however, were evident to the "instructed parent," i.e., one instructed in the use of the urinary diary, a written log of the parents' observations of the infant's voiding habits. Pyelonephritis developed early in the children with recurrent infections; it was clinically inapparent and developed in infants with (initially) normal urinary tracts.

One hundred sixty-five infants of both sexes, 2 weeks to 2 years of age, were screened by their parents at home for bacteriuria. Parents were instructed during a single brief period during the initial office visit to collect and to culture their infants' urine at home. Urine was collected by specimen bag and cultured promptly at cribside using a newly developed culture kit and inoculating swab. The same specimen was cultured by the office laboratory staff by kit and swab and, as a reference standard, by the loop-MacConkey method. Infants were screened at home after three consecutive office visits. Then, 870 specimens were processed. Urinary tract infection (UTI) was diagnosed in 3.6% of the study population. Results show that home screening of infants for UTI by the parent compares favorably with screening by the office laboratory.