Localization and Therapy of Urinary Tract Infections of Childhood

Abstract

Patients (104) with 124 episodes of urinary tract infection [UTI] were studied. Serum C-reactive protein (CRP) was determined on diagnosis of each patient. Children with a CRP equal to or greater than 30 .mu.g/ml (CRP-pos) differed significantly from those with values less than 30 .mu.g/ml (CRP-neg) in age, clinical presentation, K type of Escherichia coli causing disease, frequency or radiographic abnormalities and presence of antibody coating of bacteria in the urinary sediment. E. coli K1 strains caused disease significantly more often in CRP-pos than in CRP-neg patients; children with K1 infections were younger than those with non-K1 infections. The antibody-coated bacteria test was neither sensitive nor specific for localization of infection in pediatric patients. Determination of K1 antibody concentrations in serum and urine of E. coli K1-infected children provided data supporting the measurement of CRP as 1 means of localizing UTI. Patients with CRP-neg infections were treated as successfully with 4 days of anti-microbial therapy [amoxicillin] as with 10 days of therapy.