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Urinalysis for UTI in infants more accurate than previously reported
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Recent study data indicated that urinalysis sensitivity was higher and more diagnostically accurate in infant patients despite previous reports that it provides suboptimal results.
The researchers’ findings showed that urinalysis can accurately detect the presence of bacteremic urinary tract infection (UTI), whereas the typical suboptimal data resulted from testing for both bacteremic UTI and general UTI.
“Bacteremic UTI represent a unique and desirable condition in which to assess the sensitivity of the [urinalysis],” researcher Alan R. Schroeder, MD, from the department of pediatrics at Santa Clara Valley Medical Center, and colleagues wrote. “Infection with the same organism in the blood and urine renders contamination or asymptomatic bacteriuria extremely unlikely, thereby minimizing the probability that the urine culture represents a false positive.”
Researchers sought to measure the sensitivity of urinalysis using a multicenter sample of patients (n = 245) aged younger than 3 months. Samples from infants with bacteremic UTI from 11 hospitals were tested, along with samples from 115 infants with negative cultures, to separately measure specificity and sensitivity.
Sensitivity tested against the 245 positive samples yielded only one infant who tested negative after a complete urinalysis.
Alternate readings of these results included the possibility that previous studies of UA sensitivity were flawed due to contamination. The investigators wrote that this may be due to the challenges present in gathering clean urine samples from infants.
“Requiring a positive urinalysis to make the diagnosis of UTI could have important clinical implications,” Schroeder and colleagues wrote. “Our study highlights the need to further define the role of the urinalysis in young infants with suspected UTI to minimize the possibility of harm and excessive costs from overtreatment.” – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
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