Abstract
BACKGROUND
The clinical diagnosis of urinary tract infection (UTI) in infants under the age of 2 years is challenging because of the nonspecific symptoms and signs in this age group. Prompt diagnosis and treatment is critical, and although dipstick testing allows rapid testing, there is some doubt about its use in infants. We sought to show the use of the dipstick test in identifying or excluding UTI in infants under the age of 2 years presenting to the emergency department with a febrile illness.
METHODS
We conducted a retrospective diagnostic cohort study for over a 12-month period in a UK Paediatric Emergency Department, including all febrile children who had a urine dipstick and a quantitative culture as part of their diagnostic workup. The gold standard was the quantitative culture.
RESULTS
Three hundred and twenty-one samples were eligible for inclusion. The mean age of the children included was 9.3 months. Sixty-three percent were female children. A test positive for nitrite, leucocyte esterase and blood gave a specificity of 97.12% [95% confidence interval (CI): 94.17-98.60] and a positive likelihood ratio of 15.13 (95% CI: 6.99-32.76). A test negative for nitrite, LE, blood and protein had a sensitivity of 97.44% (95% CI: 91.12-99.29) and a negative likelihood ratio of 0.10 (95% CI: 0.02-0.39).
CONCLUSION
In febrile infants who were below 2 years of age, dipstick urinalysis shows promising results in identifying or ruling out a UTI.
TY - JOUR
T1 - Dipstick urinalysis for the emergency department evaluation of urinary tract infections in infants aged less than 2 years.
AU - Ramlakhan,Shammi L,
AU - Burke,Derek P,
AU - Goldman,Rebecca S,
PY - 2011/2/3/entrez
PY - 2011/2/3/pubmed
PY - 2011/10/8/medline
SP - 221
EP - 4
JF - European journal of emergency medicine : official journal of the European Society for Emergency Medicine
JO - Eur J Emerg Med
VL - 18
IS - 4
N2 - BACKGROUND: The clinical diagnosis of urinary tract infection (UTI) in infants under the age of 2 years is challenging because of the nonspecific symptoms and signs in this age group. Prompt diagnosis and treatment is critical, and although dipstick testing allows rapid testing, there is some doubt about its use in infants. We sought to show the use of the dipstick test in identifying or excluding UTI in infants under the age of 2 years presenting to the emergency department with a febrile illness. METHODS: We conducted a retrospective diagnostic cohort study for over a 12-month period in a UK Paediatric Emergency Department, including all febrile children who had a urine dipstick and a quantitative culture as part of their diagnostic workup. The gold standard was the quantitative culture. RESULTS: Three hundred and twenty-one samples were eligible for inclusion. The mean age of the children included was 9.3 months. Sixty-three percent were female children. A test positive for nitrite, leucocyte esterase and blood gave a specificity of 97.12% [95% confidence interval (CI): 94.17-98.60] and a positive likelihood ratio of 15.13 (95% CI: 6.99-32.76). A test negative for nitrite, LE, blood and protein had a sensitivity of 97.44% (95% CI: 91.12-99.29) and a negative likelihood ratio of 0.10 (95% CI: 0.02-0.39). CONCLUSION: In febrile infants who were below 2 years of age, dipstick urinalysis shows promising results in identifying or ruling out a UTI.
SN - 1473-5695
UR - https://www.unboundmedicine.com/medline/citation/21285881/Dipstick_urinalysis_for_the_emergency_department_evaluation_of_urinary_tract_infections_in_infants_aged_less_than_2_years_
DB - PRIME
DP - Unbound Medicine
ER -
