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Updated: Jun 19, 2026

An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection
07:57

An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection

Published on: June 24, 2025

Urinalysis Abnormalities and Culture Positivity in Children With Clean Intermittent Catheterization

Nilsun Kuas1, Aylin Gençler2

  • 1Department of Pediatric Urology, Eskişehir City Hospital, Eskişehir, Turkey.

Pediatrics International : Official Journal of the Japan Pediatric Society
|June 18, 2026
PubMed

Insights

Urinalysis tests can help predict positive urine cultures in children with neurogenic bladder undergoing clean intermittent catheterization (CIC). Combinations like nitrite or bacteriuria show promise for diagnosing urinary tract infections (UTIs).

Area of Science:

  • Pediatric Nephrology
  • Clinical Microbiology
  • Diagnostic Accuracy

Background:

  • Diagnosing urinary tract infections (UTIs) in children with neurogenic bladder is complex due to frequent bacterial colonization and unreliable symptoms.
  • Clean intermittent catheterization (CIC) is common in this population, necessitating effective UTI diagnostic strategies.

Purpose of the Study:

  • To evaluate the diagnostic performance of urinalysis parameters in predicting urine culture positivity in children with neurogenic bladder undergoing CIC.
  • To identify optimal combinations of urinalysis parameters for predicting UTI in this challenging patient group.

Main Methods:

  • Retrospective analysis of 1362 urine samples from 107 pediatric patients with neurogenic bladder undergoing CIC.
  • Evaluation of leukocyte esterase (LE), nitrite, pyuria, and bacteriuria, with culture positivity defined as ≥10^5 CFU/mL.
  • Statistical analysis including sensitivity, specificity, PPV, NPV, and likelihood ratios for individual and combined parameters using generalized estimating equations.

Main Results:

  • The combination of "Nitrite OR Bacteriuria" showed high diagnostic accuracy (AUC 0.84).
  • "LE OR Nitrite OR Bacteriuria" demonstrated excellent sensitivity (0.94) and negative predictive value (0.92), suggesting strong rule-out potential.
  • "LE AND Nitrite" offered high specificity (0.98) and positive predictive value (0.93) but low sensitivity.

Conclusions:

  • Urinalysis parameter combinations can aid in predicting urine culture positivity in children with neurogenic bladder undergoing CIC.
  • These findings highlight the utility of specific urinalysis combinations for UTI risk assessment.
  • The study acknowledges that these parameters cannot differentiate asymptomatic bacteriuria from clinically significant UTIs requiring treatment.
Abstract

Keywords:
clean intermittent catheterizationneurogenic bladderurinalysisurinary tract infection

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