Bedside diagnosis of outpatient childhood urinary tract infection using three-media dipslide culture test

Abstract

To determine the accuracy of a three-media dipslide test, the Uricult Trio, for the diagnosis of childhood urinary tract infections (UTIs), we collected urine specimens from children at the outpatient department. Two hundred consecutive patients presenting with symptoms of UTI were examined. Randomly voided, midstream, clean-catch and catheterized samples were used. Each was tested by routine laboratory culture and the dipslide test. The subjects' ages ranged from 4 months to 7 years, with a median age of 5 years. There were 112 (56%) boys and 86 (43%) girls. Of the subjects, 98 (49%) showed urine culture results indicating significant bacteriuria. There was complete agreement in 70 cases (35%). The sensitivity and specificity of the dipslide were 68% and 82%, respectively. The positive and negative predictive values were 81% and 71%, respectively. The likelihood ratio for a positive test was 3.7, while for a negative test it was 0.39. The specificity, using Escherichia coli special agar, increased to 85% and the negative predictive value to 93%. The Uricult Trio dipslide method was technically simple and could be applied in the outpatient setting. Further studies are required, however, before it can be recommended as a routine diagnostic tool.

Home screening for bacteriuria in children with spina bifida and clean intermittent catheterization

“…In a recent study in 200 children with UTI symptoms and a positive LET, Uricult® Trio dip slides incubated in a laboratory incubator were compared with colony counts on blood agar plates. The sensitivity of 68%, and a false negative rate of 29% was comparable to this study [26]. Two mayor pitfalls were found: the small pin-point colonies of some Enterococci and most Streptococci on the CLED medium were mistaken for no growth, and transparent E. coli colonies are almost invisible.…”

Diagnostic value of biomarkers for paediatric urinary tract infections in primary care: systematic review and meta-analysis

“…Bias was present for patient selection, caused by retrospective sampling ( n = 20) [ 16 , 19 , 24 , 34 – 36 , 38 , 43 , 50 , 52 , 53 , 69 , 71 , 74 , 76 , 81 , 82 , 86 , 88 , 90 ], convenience sampling ( n = 8) [ 21 , 37 , 39 , 41 , 46 , 51 , 61 , 65 ], or including a narrow spectrum of patients ( n = 4) [ 72 , 77 , 83 , 90 ]. All retrospective studies were considered at high risk for selection bias, because these studies might overestimate the diagnostic accuracy of the index test [ 26 ].…”

Urine Interleukin-1β Can Be Used for Early Prediction of Urinary Tract Infection in Children

“…Urine specimens were carried from point-oforigin to the laboratory to be analyzed without any loss of time. UTI was diagnosed in case of significant bacteriuria (≥10.000 CFU/ml) in the urine culture (2). Children of the control group were excluded from the study if they had bacterial growth in their urine.…”

“…Urinary tract infections (UTI) are one of the most frequent types of childhood infections diagnosed by pediatric clinicians. A missed diagnosis may lead to long-term medical difficulties, including hypertension and renal scarring with reduced renal function (1,2). Routine clinical practice in Turkey in cases with pyuria uses positive nitrite tests in urinalysis to detect UTI and to choose which treatment to start with.…”