[Urine samples from children collected in their homes]
Jakob Granild-Jensen1, Mette Marie Mikkelsen, Jens Erik Veirum
1Arhus Universitetshospital, Skejby, Nefrourologisk Forskningsgruppe, Paediatrisk Forskningslaboratorium A. jakobgranild@hotmail.com
Insights
Home urine sampling for children at high risk of urinary tract infection (UTI) is valuable when symptoms are present. However, asymptomatic children do not benefit from home urine sampling to prevent pyelonephritis.
Area of Science:
- Pediatric Nephrology
- Clinical Microbiology
- Public Health
Background:
- Children at high risk for urinary tract infections (UTIs) participate in a domestic urine sampling program.
- Parents collect samples, document symptoms, and mail specimens for analysis.
- The study aimed to assess the program's value and the utility of domestic urine sampling.
Purpose of the Study:
- To determine the clinical value of domestic urine sampling in pediatric UTI management.
- To evaluate the effectiveness of a home urine sampling program for high-risk children.
- To identify optimal strategies for urine sample cultivation in pediatric UTI cases.
Main Methods:
- A retrospective analysis of all urine samples collected in 2004 was performed.
- Urine samples were subjected to dip-slide analysis and subsequent cultivation.
- Clinical symptoms were correlated with laboratory findings to diagnose UTIs.
Main Results:
- Of 706 cultivated samples, 76 children met UTI criteria based on culture and symptoms.
- Dip-slide analysis demonstrated 72% sensitivity and 96% negative predictive value.
- Asymptomatic children with negative dip-slide results showed no subsequent UTI development, even if cultures were positive.
Conclusions:
- Home urine sampling for asymptomatic, high-risk children does not prevent pyelonephritis.
- A domestic urine sample analysis program is beneficial for symptomatic children, enabling early UTI treatment.
- Urine cultivation is recommended only for symptomatic children or those with a positive dip-slide test.
Introduction:
Children at high risk of urinary tract infection (UTI) enter a programme for domestic urine sampling at the Paediatric Department in Aarhus. Parents collect urine, describe symptoms and post the samples. We wanted to determine the value of domestic urine sampling and to evaluate the programme.
Material And Methods:
All samples received in 2004 were studied.
Results:
A total of 706 urine samples from children in the programme were cultivated. In all 76 children fulfilled the criteria for UTI when culture and symptoms were compared. Dip-slide analysis had a sensitivity of 72% and a negative predictive value of 96%. A total of 329 urine samples with negative dip-slide analyses were collected from children with no urinary tract symptoms. Only 27 of these samples were culture-positive and none of these children developed signs of UTI.
Conclusion:
The results from this study suggest that home urine sampling from children at high risk of UTI with no symptoms does not contribute towards avoiding the development of pyelonephritis. A home urine sample analysis programme for children with symptoms is, however, a valuable instrument for early and efficient treatment of UTI in children with high risk of UTI. Urine samples should only be cultivated if the child has symptoms or the dip-slide test is positive.
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