[Urinary tract infections in children--aspects of microbiological diagnosis]
Magdalena Stârcea1, Mihaela Munteanu, Gabriela Coman
1Clinica Recuperare Pediatrică--Puericultură, Facultatea de Medicină, Universitatea de Medicină si Farmacie Gr.T. Popa Iaşi.
Insights
Urinary tract infection (UTI) diagnosis in children benefits from additional urine cultures. Combining urinalysis with multiple cultures significantly improves sensitivity and reduces the risk of missed or over-diagnosed UTIs.
Area of Science:
- Pediatric Nephrology
- Clinical Microbiology
- Diagnostic Accuracy Studies
Context:
- Urinary tract infection (UTI) is a common childhood bacterial infection.
- Accurate diagnosis is crucial for timely treatment and preventing complications.
Purpose:
- To evaluate the diagnostic value of urine analysis (UA) for UTI in children.
- To determine the sensitivity and specificity of UA in predicting UTI.
Summary:
- A study of 700 pediatric urinary specimens assessed UA (bacteriology and biochemistry).
- Initial UA showed 56% sensitivity and 10% specificity for UTI.
- Supplementing with 2-3 urine cultures increased sensitivity to 97% and specificity to 35%.
Impact:
- Enhanced UA protocols improve UTI diagnostic accuracy in children.
- Increased sensitivity reduces the chance of missed infections and serious consequences.
- Improved specificity decreases the likelihood of over-diagnosing UTI.
Unlabelled:
Urinary tract infection (UTI) is one of the most common bacterial infections of childhood, with the incidence range between 1-1.5% in boys and 3-8% in girls.
Aim:
To estimate the value of urine analysis (bacteriology and biochemistry) for diagnostic of UTI in children.
Material And Method:
The method was to observe 700 urinary specimens collected from patients hospitalized in 4th Clinic of Pediatric Nephrology between October 2004 and February 2005, the urinalysis (UA) being performed in the Microbiology laboratory of "St. Maria" Emergency Children Hospital Iaşi. The sample collection was made from the midstream urine flow, direct microscopy and standard culture were performed immediately after collection. We applied a diagnostic strategy study in order to evaluate sensitivity and specificity of UA for prediction of UTI. The data was assessed according to the Receiver Operator Characteristic Curve.
Results And Discussion:
We analysed the relation between leukocituria and positive urine culture and we find a sensitivity equal to 56%, with CI 95% = 0.56 +/- 0.07, and a specificity equal to 10%, with CI 95% = 0.10 +/- 0.02. The likelihood of UTI with negative UA result has been calculated as a negative likelihood ratio = 4.4. If we supplement a number of culture (2-3) we have obtain a sensitivity 97% +/- 0.02%, and the predictive negative value 97% (that mean the possibility to lose UTI in just 3% cases), and a specificity 35%, with a predictive positive value 61% (that mean a decrease of possibility to over-measure UTI).
Conclusions:
The sensitivity of UA increase if we correlate more than leukocyturie and the significantly positive urine culture. We must to supplement a number of urine culture for increase the chance to obtain a positive diagnostic of UTI, and to exclude a possibility to over-measure UTI. Through increase a sensibility of method for diagnostic, decrease the possibility to loose and no treaty UTI with serious consequence.
Related Concept Videos
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:28Microbiota of the Urogenital Tract
01:26Urine Studies II: Urine Culture and Sensitivity Test
01:26Urinary Tract Infection I: Introduction
01:25Urinary Tract Infection II: Pathophysiology
01:17Urinary Tract Infection IV: Nursing Management