Clinical evaluation of a rapid diagnostic screen (URISCREEN) for bacteriuria in children

We assessed clinical use of the URISCREEN test for detecting significant bacteriuria in children and compared it to standard quantitative culture.

URISCREEN detects catalase in urine samples, reflecting the presence of at least 50,000 colony-forming units per ml. or 10 somatic cell per high power field. Catheterized urine specimens from 200 consecutive children scheduled to undergo urodynamic evaluation were tested by URISCREEN and quantitative culture methods. Sensitivity, specificity, positive and negative predictive values, and accuracy were determined.

Of these specimens there were 22 false-positive and 16 false-negative URISCREEN results. Sensitivity was 65.2%, specificity 85.7%, positive predictive value 57.7%, negative predictive value 89.2% and overall accuracy 81%.

URISCREEN is a rapid screen for bacteriuria. However, the high false-negative rate limits clinical use in the pediatric urological patient for whom detecting infection is essential.