Managing urinary tract infections

Saadeh, Sermin A.; Mattoo, Tej K.

doi:10.1007/s00467-011-1801-5

Cited by 99 publications

(73 citation statements)

References 56 publications

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“…Ultrasonography of abdomen was done in all patients. 2,3 Other special investigations like MCUG and Renal Scan were done as per Indian Pediatric Nephrology Group (IPNG) protocol and Indian Society of Pediatric Nephrology (ISPN) revised statement. 4,5 Urine samples were collected either by mid-stream-cleancatch method or by catheterization with all proper aseptic precautions.…”

Section: Methodsmentioning

confidence: 99%

“…To prevent the potentially dangerous sequel like renal scarring, early detection of UTI in childhood is essential, which depends entirely on the physician's degree of suspicion, urine routine microscopy and culture. 2 Urine culture though is considered a gold standard test to diagnose UTI, is time consuming, costly and requires good microbiology laboratory facilities. Also, the timing and method of collection of urine sample plays a major role in isolation of organisms from urine culture.…”

Section: Introductionmentioning

confidence: 99%

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Urinary tract infection in children: clinical aspects and utility of urine dipstick test

Mod¹,

Jeeyani²,

Shah³

2017

Int J Contemp Pediatr

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Background: Urinary tract infection (UTI) is a common genitourinary disease in children and accounts for significant morbidity. To prevent the potentially dangerous sequel, early detection of UTI in childhood is essential. This depends entirely on strong clinical suspicion and urine culture report. Recently, advances in investigations are taking place to diagnose UTI rapidly. Urine dipstick is one such bedside method to diagnose UTI. This study aims at studying the clinical features of UTI and evaluating sensitivity and specificity of urine dipstick in diagnosing UTI.Methods: This study was conducted at a tertiary care hospital in Vadodara from January 2013 to June 2014, on 60 children admitted with clinical suspicion of urinary tract infection. Along with study of clinical features, results of urine dipstick tests (Nitrite and Leukocyte esterase), urine microscopy and urine culture were compared. Accuracy of urine dipstick tests was assessed statistically by evaluating sensitivity, specificity, positive and negative predictive values considering urine culture as a gold standard.Results: Fever was found to be the most common presenting features (53%) in all the patients studied. The sensitivity of urine microscopy, Nitrite test and Leucocyte esterase test was 63.5%, 50% and 61% and specificity was 25%, 31% and 25% respectively. Combination of Nitrite and Leucocyte Esterase test had an improved sensitivity (68%).Conclusions: Urinary tract infection can present with variety of non-specific signs and symptoms especially in younger age. Dipstick test using Leucocyte Esterase and Nitrite together is better than urine microscopic examination alone. Urine culture as a confirmatory test still remains gold standard.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Urinary tract infection in children: clinical aspects and utility of urine dipstick test

Mod¹,

Jeeyani²,

Shah³

2017

Int J Contemp Pediatr

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“…Continuous outcome measures had a nonparametric distribution (Shapiro-Wilk's test), so they were expressed as a median (range), while categorical outcome measures were expressed as an occurrence rate and percentage. Comparisons between groups were done using the Wilcoxon test, the chi-square test 2 or Fisher's exact test, as applicable. The Statistix software, version 7 (IBM version; Analytical Software, Tallahassee, FL) was used, and a p < 0.05 was considered significant.…”

Section: Discussionmentioning

confidence: 99%

“…1 Since UTIs can lead to permanent kidney damage, it is relevant to identify and provide treatment for predisposing factors in order to reduce their frequency and, as a result, the associated morbidity. 2 These include anatomo-functional factors, such as vesicoureteral reflux (VUR) and bladder dysfunction, and metabolic factors, mainly idiopathic hypercalciuria (IH). 2,3 IH is a common pediatric disorder (3%-10%) [4][5][6] which predisposes to the development of UTI because the oversaturation of urine with calcium oxalate microcrystals may damage mucous membranes of the urinary tract.…”

Section: Introductionmentioning

confidence: 99%

“…2 These include anatomo-functional factors, such as vesicoureteral reflux (VUR) and bladder dysfunction, and metabolic factors, mainly idiopathic hypercalciuria (IH). 2,3 IH is a common pediatric disorder (3%-10%) [4][5][6] which predisposes to the development of UTI because the oversaturation of urine with calcium oxalate microcrystals may damage mucous membranes of the urinary tract. 7 Consequently, different studies have demonstrated an increase in IH prevalence in patients with UTI, 6,[8][9][10][11][12][13] although some authors have not been able to confirm such association.…”

Section: Introductionmentioning

confidence: 99%

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Idiopathic hypercalciuria in children with urinary tract infection

2014

Arch Argent Pediat

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Introduction. Idiopathic hypercalciuria (IH)predisposes to urinary tract infections (UTIs); however, there is scarce local information regarding such association. Our objectives were to estimate IH prevalence in children with UTI and to assess whether there were differences in relation to the presence or absence of vesicoureteral reflux (VUR). Additionally, the association between IH and salt intake was studied. Population and Methods. Calciuria was determined in patients younger than 18 years old on whom UTI had been studied (ultrasound and voiding cystourethrogram), and who had no secondary causes of hypercalciuria. IH was defined as a calcium to creatinine ratio of >0.8, 0.6, 0.5 and 0.2 in children aged 0 to 6 months old, 7 to12 months old, 12 to 24 months old and older than 2 years old, respectively; and a high sodium intake with a urinary sodium to potassium ratio of ≥2.5. Results. IH prevalence among 136 patients (87 girls, median age: 3 years old) was 20%. Patients with VUR (n= 54) and without VUR (n= 82) had similar characteristics in terms of sex, weight, height, age at diagnosis and age at the time of the study, and clinical features (hematuria, nephrolithiasis, colicky pain, and recurrent UTI), family history of kidney stone formation, and IH prevalence (26% versus 16%, p= 0.24). A high sodium intake was more frequently observed in children with hypercalciuria than in those with normal urine calcium levels (76% versus 46%, p= 0.007). Conclusions. IH prevalence in children with UTI was high (20%), with no differences observed between patients with and without VUR. As a recommendation, the presence of IH should be detected in children with UTI, regardless of VUR presence or absence.

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Development of a standardized Gram stain procedure for bacteria and inflammatory cells using an automated staining instrument

Chi

et al. 2020

MicrobiologyOpen

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Gram stain is a subjective and poorly controlled test, and the resultant errors often perplex laboratory scientists. To reduce errors and make Gram stain a precisely controllable and meritorious test, a standardized Gram stain procedure for bacteria and inflammatory cells was developed using an automated staining instrument in this study. Freshly expectorated sputum specimens, used as the optimized targets, were smeared on slides by laboratory technicians, defining each slide loaded with uniform matrix and monolayer cell. And then, the staining and decolorizing time, as well as the stain and decolorant volume, were optimized as 15, 105, 1, and 25 s and 1.1, 1.4, 0.3, and 0.7 ml, respectively. Culture‐positive blood specimens and original purulent fluids were used for confirming the developed standardized Gram stain procedure. Distinct tinctures of bacteria and inflammatory cells adhered to slide uniformly in a monolayer were observed, and the obtained staining results of these samples were highly consistent with their cultured results. Furthermore, according to the staining results under different staining conditions, an updated molecular mechanism of Gram stain for bacteria and the probable staining mechanism for inflammatory cells were also proposed in this study.

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Managing urinary tract infections

Cited by 99 publications

References 56 publications

Urinary tract infection in children: clinical aspects and utility of urine dipstick test

Urinary tract infection in children: clinical aspects and utility of urine dipstick test

Idiopathic hypercalciuria in children with urinary tract infection

Development of a standardized Gram stain procedure for bacteria and inflammatory cells using an automated staining instrument

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