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Diaper-embedded urine test device for the screening of urinary tract infections in children: a cohort study
Niko Paalanne1,2, Lotta Wikstedt3,4, Tytti Pokka3,4
1Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland. niko.paalanne@oulu.fi.
Insights
A novel diaper-embedded urine test device offers an easy and sensitive method for screening urinary tract infections (UTIs) in young children. This method provides immediate results, improving early detection and management of pediatric UTIs.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Diagnostics
- Urology
Background:
- Urinary tract infections (UTIs) are common in young children, necessitating efficient and sensitive screening methods.
- Current diagnostic approaches can be challenging in pediatric populations, particularly in emergency settings.
Purpose of the Study:
- To evaluate the feasibility and reliability of a novel diaper-embedded urine test device for screening pediatric UTIs.
- To compare the performance of the diaper-embedded test with conventional point-of-care dipstick tests and laboratory automated analysis.
Main Methods:
- A prospective cohort study involving young children with suspected acute UTIs at a pediatric emergency department.
- Urine samples were analyzed using a diaper-embedded test device, a point-of-care dipstick test, and laboratory automated urine chemistry analysis.
- Quantitative bacterial culture served as the gold standard for UTI confirmation.
Main Results:
- The diaper-embedded test demonstrated high sensitivity for detecting UTIs (93.1% for leukocyte screening).
- Compared to other methods, the diaper-embedded test provided immediate results, significantly reducing turnaround time.
- The study included 565 children, with 143 confirmed UTIs.
Conclusions:
- The diaper-embedded urine test device is a practical and sensitive tool for screening UTIs in young children.
- The immediate availability of results from the diaper-embedded test is a key clinical advantage for timely UTI management.
Background:
There is a need for an easy and sensitive method for screening of urinary tract infections in young children. We set out to test whether a novel diaper-embedded urine test device is feasible and reliable in screening for urinary tract infections.
Methods:
This prospective cohort study consisted of young children examined due to a suspected acute urinary tract infection at the Pediatric Emergency Department of the Oulu University Hospital, Finland. We analyzed the same urine samples using three different methods: 1) a diaper-embedded test device applied to the urine pad within the diaper, 2) a urine sample aspirated from the urine pad for the conventional point-of-care dipstick test, and 3) a urine sample aspirated from the urine pad and analyzed in the laboratory with an automated urine chemistry analyzer. The gold standard for confirming urinary tract infection was quantitative bacterial culture.
Results:
Urine samples were available from 565 children. Bacterial culture confirmed urinary tract infection in 143 children. Sensitivity of the positive leukocyte screening of the diaper-embedded urine test device was 93.1% (95% CI: 87.4-96.8) and that of the point-of-care urine dipstick analysis was 95.4% (90.3-98.3) in those with both tests results available (n = 528). The sensitivity of the positive leukocyte test of the diaper-embedded test device was 91.4% (85.4-95.5) and that of the automated analysis was 88.5% (82.0-93.3) in those with both tests available (n = 547). The time to the test result after urination was immediate for the diaper-embedded test, 1-5 min for point-of-care dipstick, and 30-60 min for laboratory-based automated urine chemistry analyzer.
Conclusions:
In this prospective study, the diaper-embedded urine test device was an easy and sensitive screening method for UTIs in young children. The main clinical benefit of the diaper-embedded urine test device was that the screening test result was available immediately after urination.
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