Using a urine dipstick to identify a positive urine culture in young febrile infants is as effective as in older patients

Velasco, Roberto; Benito, Helvia; Mozún, Rebeca; Trujillo, Juan; Merino, Pedro; Torre, Mercedes de la; Gómez, Borja

doi:10.1111/apa.12789

Cited by 29 publications

(39 citation statements)

References 28 publications

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“…Velasco et al. and Glissmeyer et al. studied the validity of dipstick tests of urine from bladder catheterisation and found that the sensitivity and specificity of leukocyte esterase and, or, nitrites were similar to our results.…”

Section: Discussionsupporting

confidence: 88%

“…Many studies have evaluated the accuracy of dipstick tests as a screening technique for UTIs and most of these studies included few infants who were less than 90 days old. Multicentre studies included infants who were less than 90 days old with fever without a source . Velasco et al.…”

Section: Discussionmentioning

confidence: 99%

“…Leukocyte esterase and nitrites are indirect markers of inflammation and infection of the urinary tract. The urine used for UTI screening in infants under 90 days of age is usually obtained through invasive methods, such as catheterisation or bladder taps , but these have been associated with complications and discomfort for the patient and the family. Herreros et al.…”

Section: Introductionmentioning

confidence: 99%

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Performing a urine dipstick test with a clean‐catch urine sample is an accurate screening method for urinary tract infections in young infants

et al. 2017

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Performing a urine dipstick test with a clean‐catch urine sample is an accurate screening method for urinary tract infections in young infants

et al. 2017

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“…The addition of microscopy would slightly increase the NPV to 99.2 %, but resulting in eight false-positives for every missed AP. More recently, Velasco et al [27] focusing on the leukocyte esterase test only showed that dipstick use has the same accuracy in young febrile infants as in older children.…”

Section: Diagnosismentioning

confidence: 99%

Acute pyelonephritis in children

et al. 2015

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Acute pyelonephritis is one of the most serious bacterial illnesses during childhood. Escherichia coli is responsible in most cases, however other organisms including Klebsiella, Enterococcus, Enterobacter, Proteus, and Pseudomonas species are being more frequently isolated. In infants, who are at major risk of complications such as sepsis and meningitis, symptoms are ambiguous and fever is not always useful in identifying those at high risk. A diagnosis of acute pyelonephritis is initially made on the basis of urinalysis; dipstick tests for nitrites and/or leukocyte esterase are the most accurate indicators of infection. Collecting a viable urine sample for urine culture using clean voided methods is feasible, even in young children. No gold standard antibiotic treatment exists. In children appearing well, oral therapy and outpatient care is possible. New guidelines suggest less aggressive imaging strategies after a first infection, reducing radiation exposure and costs. The efficacy of antibiotic prophylaxis in preventing recurrence is still a matter of debate and the risk of antibiotic resistance is a warning against its widespread use. Well-performed randomized controlled trials are required in order to better define both the imaging strategies and medical options aimed at preserving long-term renal function.

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“…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.…”

Section: Discussionmentioning

confidence: 88%

Outpatient management of selected young febrile infants without antibiotics

et al. 2016

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Using a urine dipstick to identify a positive urine culture in young febrile infants is as effective as in older patients

Abstract: The leucocyte esterase test showed the same accuracy in young febrile infants as previously reported findings for older children. It predicted positive urine cultures and also revealed important gender differences.

Cited by 29 publications

References 28 publications

Performing a urine dipstick test with a clean‐catch urine sample is an accurate screening method for urinary tract infections in young infants

Performing a urine dipstick test with a clean‐catch urine sample is an accurate screening method for urinary tract infections in young infants

Acute pyelonephritis in children

Outpatient management of selected young febrile infants without antibiotics

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