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Optimal diagnostic testing for urinary tract infection in young children.
Pediatr Dev Pathol. 2004 May-Jun; 7(3):226-30.PD

Abstract

Urinary tract infection (UTI) is a major concern in young febrile children. Current recommendations favor use of urine obtained by bladder catheterization or aspiration, but opinion varies as to the best ancillary tests to predict a positive culture and guide initial management. The utility of dipstick leukocyte esterase, blood, and nitrite; unspun urine leukocyte count; gram stain of cytocentrifuged urine; and standard spun sediment examination was evaluated in 142 febrile, < 5-year-old children seen in the Emergency Department, 25 of whom had culture-proven UTI. Using sensitivity and negative predictive values as criteria for performance, unspun urine leukocyte count and gram stain of cytocentrifuged urine used in parallel was the best approach but still failed to detect some UTI. Analysis of the nature of the specimens evaluated provided explanation of differences from previous observations. Adoption of this modified approach to prediction of urinary tract infection appears to improve prediction but has operational implications and creates potential problems for the laboratory.

Authors+Show Affiliations

Department of Pediatrics, Akron Children's Hospital, One Perkins Square, Akron, OH 44308, USA. rnovak@chmca.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15022064

Citation

Novak, Robert, et al. "Optimal Diagnostic Testing for Urinary Tract Infection in Young Children." Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society, vol. 7, no. 3, 2004, pp. 226-30.
Novak R, Powell K, Christopher N. Optimal diagnostic testing for urinary tract infection in young children. Pediatr Dev Pathol. 2004;7(3):226-30.
Novak, R., Powell, K., & Christopher, N. (2004). Optimal diagnostic testing for urinary tract infection in young children. Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society, 7(3), 226-30.
Novak R, Powell K, Christopher N. Optimal Diagnostic Testing for Urinary Tract Infection in Young Children. Pediatr Dev Pathol. 2004 May-Jun;7(3):226-30. PubMed PMID: 15022064.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optimal diagnostic testing for urinary tract infection in young children. AU - Novak,Robert, AU - Powell,Keith, AU - Christopher,Norman, Y1 - 2004/03/17/ PY - 2003/08/27/received PY - 2003/12/20/accepted PY - 2004/3/17/pubmed PY - 2004/12/16/medline PY - 2004/3/17/entrez SP - 226 EP - 30 JF - Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society JO - Pediatr Dev Pathol VL - 7 IS - 3 N2 - Urinary tract infection (UTI) is a major concern in young febrile children. Current recommendations favor use of urine obtained by bladder catheterization or aspiration, but opinion varies as to the best ancillary tests to predict a positive culture and guide initial management. The utility of dipstick leukocyte esterase, blood, and nitrite; unspun urine leukocyte count; gram stain of cytocentrifuged urine; and standard spun sediment examination was evaluated in 142 febrile, < 5-year-old children seen in the Emergency Department, 25 of whom had culture-proven UTI. Using sensitivity and negative predictive values as criteria for performance, unspun urine leukocyte count and gram stain of cytocentrifuged urine used in parallel was the best approach but still failed to detect some UTI. Analysis of the nature of the specimens evaluated provided explanation of differences from previous observations. Adoption of this modified approach to prediction of urinary tract infection appears to improve prediction but has operational implications and creates potential problems for the laboratory. SN - 1093-5266 UR - https://www.unboundmedicine.com/medline/citation/15022064/Optimal_diagnostic_testing_for_urinary_tract_infection_in_young_children_ DB - PRIME DP - Unbound Medicine ER -