Decreased incidence of urinary tract infections in febrile infants aged ≤60 days during COVID-19 pandemic

Acta Paediatr. 2024 Aug;113(8):1934-1939. doi: 10.1111/apa.17256. Epub 2024 Apr 27.

Abstract

Aim: To investigate the incidence rate of urinary tract infections (UTIs) among febrile infants aged ≤60 days before, during, and after the COVID-19 pandemic.

Methods: We conducted a retrospective study in 2 Swedish paediatric emergency departments between 2014 and 2022. We included full-term infants aged ≤60 days with fever without source. We calculated the annual incidence rate of UTI per 1000 births.

Results: We included 1589 full-term infants with fever without source. In 2020, 89 infants were evaluated in the emergency department versus 203-259 in 2017-2019. In 2020, the incidence rate of UTI was 1.43 per 1000 births/year versus 2.18-2.37 in 2017-2019. The median age, sex, fever duration, and urine testing were similar between the years 2017 and 2020.

Conclusion: The number of febrile infants who presented to the paediatric emergency department and the incidence rate of UTIs decreased in 2020. This decrease might imply a systematic misdiagnosis of UTIs in infants with febrile viral infections. A more selective urine testing approach for febrile, previously healthy, infants should be considered to mitigate UTI misdiagnosis and its potential harmful effects.

Keywords: COVID‐19; febrile infants; misdiagnosis; urinary tract infection; urine dipstick.

Publication types

  • Multicenter Study

MeSH terms

  • COVID-19* / epidemiology
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Fever / epidemiology
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Retrospective Studies
  • Sweden / epidemiology
  • Urinary Tract Infections* / diagnosis
  • Urinary Tract Infections* / epidemiology