A bacteriologic study of samples of urine from 41 patients (27 infants and 14 children) with acute gastroenteritis and with diarrhea as a symptom was carried out.
Clean-voided urine samples from 22 of the 27 infants (less than 2 years of age) with diarrhea contained fewer than 10,000 organisms per milliliter; in 2 cases in which the counts were between 9,000 and 10,000, catheter samples obtained simultaneously were sterile. Three of the five infants with more than 10,000 organisms/ml of cleanvoided urine had fewer than 140 organisms/ml in catheter samples obtained at the same time; the remaining two had more than 100,000 organisms/ml and were presumed to have infection of the urinary tract.
Of the 14 children (over 2 years of age), 13 had fewer than 1,000 organisms/ml of clean-voided urine. The remaining one had more than one-million organisms/ml from both a clean-voided and catheter sample and was presumed to have infection of the urinary tract. Of the 41 patients with diarrhea, 3 (7%) had a significant bacteriuria (i.e., more than 10,000 organisms/ml of urine in infants, and more than 1,000 organisms/ml of urine in children), and were considered to have an infection of the urinary tract. It is of interest that each of these three patients had specffic gastroenteritis; one had a gastroenteritis due to Shigella sonnei, and two had an infection due to pathogenic enteric strains of Escherichia coli (055 and 0111); all three were girls, 1 month, 12 months and 7 years of age. Thus, 3 of 16 patients (19%) with specific gastroenteritis had bacteriologic evidence of infection of the urinary tract. Urine cultures for the three girls revealed organisms other than those isolated from cultures of stools.
The significance of the finding that only those patients with specific gastroenteritis were found to have a true bacteriuria and then only in girls, and that urine cultures in those patients with a true bacteriuria revealed organisms other than those isolated from the stool specimens is not clear and deserves further study.
The relationship of acute gastroenteritis to the pathogenesis of renal infection is discussed briefly, and consideration is given to the possible role disturbance in acid-base equilibrium may play in the pathogenesis of renal infection.