Presentation Authors: Hye Jin Byun*, Wonho Jung, Ji Yong Ha, Byung Hoon Kim, Chol Hee Park, Chun Il Kim, Daegu, Korea, Republic of
Introduction: Infants are vulnerable to fever and require rapid diagnosis and treatment. It is difficult to find the cause of fever in infants. Urinary tract infection (UTI) is one of the most common bacterial infections in febrile infants and its prevalence is especially high in infants younger than 3 months. Delayed diagnosis and management of UTI can result in renal damage and loss of renal function. Although urine culture is the standard approach to confirm the diagnosis of UTI, it takes a long time to obtain the results. It has become clear that obesity is associated with a variety of infectious diseases, including UTI. The aim of this study was to evaluate the association between obesity and the degree of febrile UTI (fUTI) in infants with fever.
Methods: A total of 492 patients aged < 3 months were admitted to Keimyung University Dongsan Medical Center due to fever (body temperature â‰¥ 38Â°C) without a source between January and December 2016, and we retrospectively reviewed the medical records of 422 patients. Overweight or obese status of the patients was defined using weight-for-length (WFL) measurements. They were divided into three groups as follows; the standard ( < 85%), the overweight (85-95%), and the obese (â‰¥95%) groups, based on a recent report that identified obesity in young children. We compared the following clinical and laboratory variables: gender, age (days), degree of obesity, degree of inflammation at the time of admission according to the presence or absence of UTI.
Results: We reviewed the data of 492 patients and excluded 70 patients. Among 422 patients (M:F=267:155; mean age=56.4 days), 102 (24.2%) patients were classified into the UTI group and 320 (75.8%) into the non-UTI group. UTI occurred more frequently in infants with obesity and they were associated with a higher grade of serum WBC count, CRP, pyuria grade, and positive urine nitrites (p < 0.001, respectively).
Conclusions: We have shown that obesity has an effect on fUTI in infants < 3 months of age. If the degree of obesity is high, it can help in the early diagnosis and treatment of UTI in febrile infants < 3 months of age with non-specific symptoms. Also, we should perform a close follow-up and actively consider treatment for obesity.