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Certain tests more accurate in diagnosing childhood UTIs
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MEMPHIS, Tenn. — Accurate screening tests of childhood urinary tract infections could enable antibiotic treatment earlier in the course of infection, prevent unnecessary antibiotic use and adverse effects, hinder the emergence of resistant uropathogens, and reduce costs, according to data presented at the St. Jude/PIDS Pediatric Infectious Diseases Research Conference.
Researchers retrospectively compared results of automated urinalysis and urine cultures from children in two age groups (younger than 24 months and aged 2-18 years).
They studied the results of automated urinalysis and compared them with the following four urine cultures results: 1) growth of a single uropathogen with a colony count ≥50,000 colony-forming units (CFU) per mL; 2) colony count ≥10,000 CFU/mL to ˂50,000 CFU/mL; 3) contaminants; and 4) cultures with no growth.
Of the 266 positive cultures, 38% had a single uropathogen with a colony count ≥50,000 CFU/mL, and 9% of cultures were positive for a single uropathogen with a colony count ≥10,000 CFU/mL to <50,000 CFU/mL; 53% were considered contaminants. Researchers found that leukocyte esterase was more sensitive and specific to the younger study group, whereas pyuria was a more effective indicator among children aged 2 to 18 years. Sensitivity and specificity of nitrite were similar in both groups.
Asif Noor, MBBS, of Stony Brook Long Island Children’s Hospital, and colleagues concluded that leukocyte esterase is more accurate in screening for UTIs among children younger than 2 years, whereas pyuria is a better indicator among older children. The researchers plan to assess the use of urine Gram’s stain in screenings and appropriate antibiotic treatment in a prospective study.
Asif Noor
“Physicians have to make sure they understand that each and every component has to be the focus,” Noor told Infectious Diseases in Children. “You can’t pick one component, for urinalysis, the whole picture is what matters.”
For more information:
Noor A. Abstract 201426. Presented at: St. Jude/PIDS Pediatric Infectious Diseases Research Conference 2014; Feb. 21-22, 2014; Memphis, Tenn.
Disclosure: The researchers report no relevant financial disclosures.