Use of Urine Dipstick Evaluating Young Infants With Fever Without a Source and Positive Urine Culture

Abstract

We analyzed 239 febrile infants <3 months of age with a positive urine culture to examine their characteristics. Patients with altered urine dipstick showed more commonly alterations of the biologic markers for bacterial infection, and Escherichia coli was more commonly isolated. Febrile young infants with positive urine culture and negative urine dipstick may not have a urinary tract infection and less aggressive management can be considered.

Outpatient management of selected young febrile infants without antibiotics

“…Thus, admission and antibiotic treatment may not be necessary for all these patients 30 31. Most of our patients were well when the result of the urine culture arrived and were managed without antibiotics, on the assumption they were not suffering from a true UTI.…”

Urinary tract infection in young infants discharged from the emergency room with normal urinalysis

“…In general, the use of urinalysis by dipstick is accepted as a reliable technique which predicts UTI in all ages . On the other hand, the presence or absence of pyuria is findings not reliable enough to diagnose or rule out UTI.…”

“…In respect to this question, we consider that three possible answers should be considered: (i) The negative urinalysis by dipstick in the presence of a positive urine culture in a patient with a true UTI is related to the limitations of a laboratory test not sensitive enough; (ii) The positive urine culture is due to contamination of the urine during the catheterisation or midstream urine collection process; and (iii) The positive urine culture represents asymptomatic bacteriuria, a condition of urine colonisation with uropathogens without appropriate clinical symptoms. In general, the use of urinalysis by dipstick is accepted as a reliable technique which predicts UTI in all ages (13,14,(16)(17)(18)(19). On the other hand, the presence or absence of pyuria is findings not reliable enough to diagnose or rule out UTI.…”

Comparison of screening tests of asymptomatic bacteriuria in pregnancy in a Tertiary Care Hospital, Solapur

“…But gold standard method for diagnosis of UTI is urine culture. 6 Up to 18 hours are required for bacterial growth on culture media by standard laboratory techniques, 7 which means that the condition remains undiagnosed for the first 24-48 hours after presentation, which leads to delay in the treatment.…”