The Diagnosis of UTI: Liquid Gold and the Problem of Gold Standards

Performance of urinalysis tests and their ability in predicting results of urine cultures: a comparison between automated test strip analyser and flow cytometry in various subpopulations and types of samples

“…In infants, urinalysis has regained interest as can be seen in several publications in the last five years 2 3 9 10. Traditionally, the sensitivity of the urinalysis has been considered suboptimal in young infants3 9 and the results of our study support this notion.…”

“…The gold standard in diagnosing urinary tract infections (UTIs) is urine culture 1 2. Because urine culture results are not available within 24 hours, tests that may predict results of urine culture and enable the initiation of therapy at the first encounter are needed 3.…”

“…In the last few years, there is a renewed interest in the use of urinalysis in a specific population such as paediatric patients2 3 9–11 and in predicting urine samples that will turn to be negative 4. Studies on test strip analyser were often performed manually 12.…”

What Urinary Colony Count Indicates a Urinary Tract Infection in Children?

“…The risks of underdiagnosis must be balanced against the risks of overdiagnosis, especially for the symptomatic child with bacteriuria without pyuria 17 . The likelihood of overdiagnosis in the RIVUR cohort was minimized because all the patients identified with a recurrent UTI had pyuria and symptoms or fever.…”

Interpretation of pyuria in children with urinary tract infection

“…Moreover, a link between urinary tract abnormalities and UTI caused by non‐ E. coli uropathogen has been documented . In children with UTI, both underdiagnosis and overdiagnosis are challenges: if untreated, there is a risk of renal scarring . However, if children with asymptomatic UTI are overtreated, they may be harmed by the development of an increased chance of symptomatic infection .…”