e80 13th International Congress on Infectious Diseases Abstracts, Poster Presentations blood and Streptococcus pyogenes in pleural fluid. Treat- ment consisted of: antibiotics only, n = 3 (7.9%); chest drain only, n = 5 (13.2%); chest drain with fibrinolytics, n = 14 (36.8%); primary video-assisted thoracoscopic surgery, n = 16 (42.1%). Conclusion: Identification by culture positive organisms alone suggest Streptococcus pyogenes and Streptococcus pneumoniae are the leading causes of childhood empyema in Australia. There is a wide discrepancy in treatment approaches. The next step, while continuing to recruit sub- jects, is to use molecular techniques to identify and type bacteria in culture positive and negative pleural fluid. Funding: Supported by an unrestricted grant from Glax- oSmithKline, Belgium. doi:10.1016/j.ijid.2008.05.198 15.043 Enhanced Urinalysis in Febrile Children with Suspected Urinary Tract Infection S. Aroor * , N. Bhaskaranand, P. Kini Kasturba Medical College, Udupi, India Objective: To study the results of enhanced urinalysis in febrile children with suspected urinary tract infection and to compare the results of enhanced urinalysis with standard urinalysis. Methods: Febrile children between one month to 18 years of age with clinical features suggestive of urinary tract infec- tion or with unexplained fever, attending department of paediatrics formed the subjects of the study. Standard and enhanced urinalysis were performed in all the cases. For enhanced urinalysis a drop of fresh unspun and unstained urine was placed on an improved Neubaur haemocytometer and examined under high dry magnification for the presence of pyuria (reported as wbc/cumm). Urine specimens were also sent for culture tests. Results: Total of 253 children were included in the study of whom 148 were males and 105 were females. Mean age was 3.6 years. Culture was positive in 42 specimens. Out of 39 cases who had significant pyuria by standard urinal- ysis, 28 (71%) were found to be culture positive. Where as out of 50 cases who had significant pyuria by enhanced uri- nalysis, 38(76%) had positive urine culture. However out of 214 cases negative for pyuria by standard method, fourteen (6.5%) cases were culture positive. For almost same number of pyuria negative cases by enhanced method (203), only 4 cases (1.9%) were culture positive. Accordingly enhanced urinalysis showed higher sensitivity (90% Vs 66%) with a greater positive predictive value (76% Vs 71.8%) when com- pared to standard urinalysis. Conclusion: Enhanced urinalysis has a greater sensitivity and positive predictive value compared to standard urinal- ysis in children with urinary tract infections and a negative enhanced urinalysis almost rules out UTI (negative predic- tive value - 97.5%). doi:10.1016/j.ijid.2008.05.199 15.044 Diarrheal Etiology in Children Under Five in Bulgaria - A Prospective Study - Preliminary Results V. Nedkova 1 , R. Komitova 2,* , V. Popova 2 , H. Hitkova 2 , Z. Mladenova 3 , N. Korsun 3 , Z. Petkova 2 1 Medical University, Pleven, Bulgaria 2 University Hospital, Pleven, Bulgaria 3 National institute of Infectious and Parazitic Dideases, Sofia, Bulgaria Background: Infectious diarrheal diseases remain an important cause of high morbidity in children younger than 5 years of age. The knowledge of the childhood diarrhea is necessary to develop practice guidelines for the most appro- priate stool examination procedures. We undertook a 1-year prospective study of the etiology, epidemiology and clinical features of infectious diarrhea in hospitalized children under five. Here we present the pre- liminary results for the first 7 months. Methods: We evaluated children under 5 with infec- tious diarrhea, hospitalized in Pediatrics Clinic, University Hospital, Pleven, from June to December 2007. Thermotol- erant Campilobacter, Salmonella, Yersinia, Shigella and E. coli were detected by standard methods. Rotaviruses were detected by ELISA and RT-PCR. Clinical and epidemiological data were recorded and analyzed in relation to microbio- logic findings. Results: A total of 152 children, male/female 100/52 from 5 to 30 months, were enrolled in the study. Bacterial pathogens were found in 30/152 (20%) cases (Salmonella in 14 specimens, E. coli - in 8, Shigella - in 3, Campylobacter - in 4 and Yersinia enterocolitica- in one) and rotaviruses - in 25/81 (31%). Overall, 37 (60%) of 62 chil- dren whose stool specimens underwent a complete battery of tests were found to be carrying at least one pathogen. Samples from 2 patients have yielded both bacterial and viral pathogens. Conclusion: More than a half of the children tested had a definite pathogen. Rotavirus was the most common pathogen detected. The final results of this ongoing study might be useful for planning strategies for proper clinical investigation and control of childhood infectious diarrhea. doi:10.1016/j.ijid.2008.05.200 15.045 Rotavirus Infections in Northern Bulgaria R. Komitova 1,* , V. Nedkova 2 , Z. Mladenova 3 , N. Korsun 3 , V. Popova 1 , H. Hitkova 1 , Z. Petkova 1 , R. Stoyanova 1 1 University Hospital, Pleven, Bulgaria 2 Medical University, Pleven, Bulgaria 3 National Center of Infectious and Parazitic Diseases, Sofia, Bulgaria Rotaviruses (RV) are the single most important cause of severe acute gastroenteritis worldwide. The spectrum of illness ranges from asymptomatic infection to severe dehy- dration resulting from vomiting and diarrhea. Objective: to investigate rotavirus gastroenteritis among children under 5 years of age and to determine the clinical picture of the disease.