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Dipstick urinalysis for the emergency department evaluation of urinary tract infections in infants aged less than 2 years.
Eur J Emerg Med. 2011 Aug; 18(4):221-4.EJ

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.

Authors+Show Affiliations

Emergency Department, Sheffield Children's Hospital, NHS Foundation Trust, Western Bank, Sheffield, UK. sramlakhan@nhs.netNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21285881

Citation

Ramlakhan, Shammi L., et al. "Dipstick Urinalysis for the Emergency Department Evaluation of Urinary Tract Infections in Infants Aged Less Than 2 Years." European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine, vol. 18, no. 4, 2011, pp. 221-4.
Ramlakhan SL, Burke DP, Goldman RS. Dipstick urinalysis for the emergency department evaluation of urinary tract infections in infants aged less than 2 years. Eur J Emerg Med. 2011;18(4):221-4.
Ramlakhan, S. L., Burke, D. P., & Goldman, R. S. (2011). Dipstick urinalysis for the emergency department evaluation of urinary tract infections in infants aged less than 2 years. European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine, 18(4), 221-4. https://doi.org/10.1097/MEJ.0b013e3283440e88
Ramlakhan SL, Burke DP, Goldman RS. Dipstick Urinalysis for the Emergency Department Evaluation of Urinary Tract Infections in Infants Aged Less Than 2 Years. Eur J Emerg Med. 2011;18(4):221-4. PubMed PMID: 21285881.
* Article titles in AMA citation format should be in sentence-case
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 -