Defining urinary tract infection in the critically ill child.

Objective: To define urinary tract infections in critically ill children in the intensive care unit setting for the purpose of surveillance of infection, enrollment of children in sepsis trials, and for trials of therapy and prevention.

Design: Summary of the literature with review and consensus by experts in the field.

Results: A variety of definitions, only some of which have been validated for use in children, were identified. The Centers for Disease Control criteria for the definition of nosocomial infection have been used to establish surveillance data for inter-institutional comparison. Validated definitions for the febrile child were identified. Using the known characteristics of symptoms, signs, and laboratory criteria for urinary tract infections, definitions for definite, possible, and probable urinary tract infection were derived.

Conclusions: Definitions for definite, probable, and possible urinary tract infection were achieved by consensus that can be used for surveillance and enrolment in sepsis trials. Future research should determine the utility of these definitions in the critically ill child and adapt them accordingly.