{
  "abstract": "Objectives To evaluate the appropriateness of the American Academy of Pediatrics’ (AAP) recommendation to no longer collect a urine culture (UC) in febrile infants ≥21 days old with negative urinalysis, and to identify predictors for having a positive UC in well-appearing febrile infants aged 22–90 days with a negative urinalysis.Methods This study was a subanalysis of a multicentre retrospective registry, including well-appearing febrile infants aged 22–90 days with a negative urinalysis between 2011 and 2022. We performed a multivariate regression analysis including the following variables: age, sex, duration of fever, maximum temperature, absolute neutrophil count (ANC), and C reactive protein and procalcitonin levels.Results We included 2391 infants in the study. The UC was positive in 177 (7.4%; 13.5% in males vs 0.6% in females). The main isolated microorganisms were Escherichia coli (83, 46.9%), Enterococcus faecalis (40, 22.6%) and Klebsiella spp (24, 13.6%). Positive UCs were positively associated with male sex (OR 9.0; 95% CI 4.7 to 16.9) and ANC (OR 1.0001; 95% CI 1.00003 to 1.0002).Conclusion Our findings support the AAP’s recommendation to avoid obtaining a UC in female infants aged 22–90 days with a negative urinalysis. Blood tests demonstrated low performance in predicting a positive UC. This finding and the extremely low prevalence of circumcision in our setting suggest that most positive UCs in males with a negative urinalysis are more likely to represent contamination, as noted by the AAP.",
  "authors": [
    {
      "affiliations": [
        "Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain",
        "Instituto de Investigación Sanitaria Hospital La Princesa, Madrid, Spain"
      ],
      "name": "Jose Antonio Alonso-Cadenas"
    },
    {
      "affiliations": [
        "Pediatric Emergency Department, Cruces University Hospital, Barakaldo, Spain",
        "Biocruces Bizkaia Health Research Institute, Barakaldo, Spain"
      ],
      "name": "Borja Gomez"
    },
    {
      "affiliations": [
        "Pediatric Emergency Unit, Hospital Universitario Rio Hortega, Valladolid, Spain",
        "Parc Tauli Health Research Institute (I3PT-CERCA), Sabadell, Spain",
        "Paediatrics & Child Health, University College Cork, Cork, Ireland"
      ],
      "name": "Roberto Velasco"
    },
    {
      "affiliations": [
        "Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain"
      ],
      "name": "Maria Suarez-Bustamante Huélamo"
    },
    {
      "affiliations": [
        "Cruces University Hospital, Barakaldo, Spain"
      ],
      "name": "Leticia Pérez Garnica"
    },
    {
      "affiliations": [
        "Hospital Infantil Universitario Niño Jesús, Madrid, Spain"
      ],
      "name": "Elena Sánchez Arranz"
    },
    {
      "affiliations": [
        "Parc Taulí Hospital Universitari, Sabadell, Spain"
      ],
      "name": "Cristina Ibarzo Port"
    },
    {
      "affiliations": [
        "Pediatric Emergency Department, Cruces University Hospital, Barakaldo, Spain",
        "Biocruces Bizkaia Health Research Institute, Barakaldo, Spain",
        "University of the Basque Country, Bilbao, Spain"
      ],
      "name": "Santiago Mintegi"
    }
  ],
  "title": "Urine culture findings in well-appearing febrile infants aged 22–90 days with negative urinalysis",
  "uid": "10c184f6-7ca7-580d-8573-cc72cde4666d"
}