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A head-to-head comparison: "clean-void" bag versus catheter urinalysis in the diagnosis of urinary tract infection in young children.
J Pediatr. 2005 Oct; 147(4):451-6.JPed

Abstract

OBJECTIVE

To compare the validity of the urinalysis on clean-voided bag versus catheter urine specimens using the catheter culture as the "gold" standard.

STUDY DESIGN

This is a cross-sectional study of 303 nontoilet-trained children under age 3 years at risk for urinary tract infection (UTI) who presented to a children's hospital emergency department. Paired bag and catheter specimens were obtained from each child and sent for dipstick and microscopic urinalysis. Sensitivity and specificity were compared using McNemar's chi2 test for paired specimens and the ordinary chi2 test for unpaired comparisons.

RESULTS

The bag dipstick was more sensitive than the catheter dipstick for the entire study sample: 0.85 (95% confidence interval [CI]=0.78 to 0.93) versus 0.71 (95% CI=0.61 to 0.81), respectively. Both bag and catheter dipstick sensitivities were lower in infants < or =90 days old (0.69 [95% CI=0.44 to 0.94] and 0.46 [95% CI=0.19 to 0.73], respectively) than in infants >90 days old (0.88 [95% CI=0.81 to 0.96] and 0.75 [95% CI=0.65 to 0.86], respectively). Specificity was consistently lower for the bag specimens than for the catheter specimens: 0.62 (95% CI=0.56 to 0.69) versus 0.97 (95% CI=0.95 to 0.99), respectively.

CONCLUSIONS

Urine collection methods alter the diagnostic validity of urinalysis. These differences have important implications for the diagnostic and therapeutic management of children with suspected UTI.

Authors+Show Affiliations

Division of Pediatric Emergency Medicine, Department of Pediatrics, and Clinical Research Centre, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada. david.mcgillivray@muhc.mcgill.caNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

16227029

Citation

McGillivray, David, et al. "A Head-to-head Comparison: "clean-void" Bag Versus Catheter Urinalysis in the Diagnosis of Urinary Tract Infection in Young Children." The Journal of Pediatrics, vol. 147, no. 4, 2005, pp. 451-6.
McGillivray D, Mok E, Mulrooney E, et al. A head-to-head comparison: "clean-void" bag versus catheter urinalysis in the diagnosis of urinary tract infection in young children. J Pediatr. 2005;147(4):451-6.
McGillivray, D., Mok, E., Mulrooney, E., & Kramer, M. S. (2005). A head-to-head comparison: "clean-void" bag versus catheter urinalysis in the diagnosis of urinary tract infection in young children. The Journal of Pediatrics, 147(4), 451-6.
McGillivray D, et al. A Head-to-head Comparison: "clean-void" Bag Versus Catheter Urinalysis in the Diagnosis of Urinary Tract Infection in Young Children. J Pediatr. 2005;147(4):451-6. PubMed PMID: 16227029.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A head-to-head comparison: "clean-void" bag versus catheter urinalysis in the diagnosis of urinary tract infection in young children. AU - McGillivray,David, AU - Mok,Elise, AU - Mulrooney,Edward, AU - Kramer,Michael S, PY - 2004/03/29/received PY - 2005/04/08/revised PY - 2005/05/04/accepted PY - 2005/10/18/pubmed PY - 2005/12/13/medline PY - 2005/10/18/entrez SP - 451 EP - 6 JF - The Journal of pediatrics JO - J Pediatr VL - 147 IS - 4 N2 - OBJECTIVE: To compare the validity of the urinalysis on clean-voided bag versus catheter urine specimens using the catheter culture as the "gold" standard. STUDY DESIGN: This is a cross-sectional study of 303 nontoilet-trained children under age 3 years at risk for urinary tract infection (UTI) who presented to a children's hospital emergency department. Paired bag and catheter specimens were obtained from each child and sent for dipstick and microscopic urinalysis. Sensitivity and specificity were compared using McNemar's chi2 test for paired specimens and the ordinary chi2 test for unpaired comparisons. RESULTS: The bag dipstick was more sensitive than the catheter dipstick for the entire study sample: 0.85 (95% confidence interval [CI]=0.78 to 0.93) versus 0.71 (95% CI=0.61 to 0.81), respectively. Both bag and catheter dipstick sensitivities were lower in infants < or =90 days old (0.69 [95% CI=0.44 to 0.94] and 0.46 [95% CI=0.19 to 0.73], respectively) than in infants >90 days old (0.88 [95% CI=0.81 to 0.96] and 0.75 [95% CI=0.65 to 0.86], respectively). Specificity was consistently lower for the bag specimens than for the catheter specimens: 0.62 (95% CI=0.56 to 0.69) versus 0.97 (95% CI=0.95 to 0.99), respectively. CONCLUSIONS: Urine collection methods alter the diagnostic validity of urinalysis. These differences have important implications for the diagnostic and therapeutic management of children with suspected UTI. SN - 0022-3476 UR - https://www.unboundmedicine.com/medline/citation/16227029/A_head_to_head_comparison:_"clean_void"_bag_versus_catheter_urinalysis_in_the_diagnosis_of_urinary_tract_infection_in_young_children_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(05)00406-3 DB - PRIME DP - Unbound Medicine ER -