Concomitant bacterial meningitis and urinary tract infection in infants: a systematic review and meta-analysis
Bibliographic record
Abstract
INTRODUCTION: Febrile infants often undergo septic workups, with urinary tract infection (UTI) being the most common serious bacterial infection. However, lumbar puncture practices vary, and the rate of concurrent meningitis remains uncertain. This systematic review and meta-analysis aimed to determine the rate of concomitant bacterial meningitis in febrile infants with UTI. METHODS: MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and conference proceedings from inception to August 2023 were searched. Included studies involved febrile infants ≤90 days old with UTI and no clear infection source, where ≥10 infants underwent lumbar puncture. Studies with localising symptoms of another diagnosis or premature infants were excluded. Studies were independently reviewed and data were extracted. Meta-analysis was performed using random-effects models with heterogeneity tests. Study quality was assessed via the Newcastle-Ottawa Scale. RESULTS: Thirty-nine observational studies met the eligibility criteria. The prevalence of concomitant definite bacterial meningitis in febrile infants with UTI was 0.3% (95% confidence interval [CI] 0.1%-0.4%). Between-studies comparison suggested this rate may be higher in neonates (≤28 days) than older infants (29-90 days old) (pooled estimate 0.7%, 95% CI 0.3%-1.1% vs. 0.2%, 0.0%-0.3%), while within-studies comparison showed no risk difference between the two groups. No association between bacterial meningitis and bacteraemia in infants with febrile UTI was observed. CONCLUSION: In clinically well febrile infants without symptoms or signs suggesting meningitis, a screening urine sample should be recommended instead of a routine full septic workup.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.011 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".