Rapid tests and urine sampling techniques for the diagnosis of urinary tract infection (UTI) in children under five years: a systematic review

Penny Whiting, Marie Westwood, Ian Watt, Julie Cooper, Jos Kleijnen

Research output: Contribution to journalArticle (Academic Journal)peer-review

105 Citations (Scopus)

Abstract

BACKGROUND: Urinary tract infection (UTI) is one of the most common sources of infection in children under five. Prompt diagnosis and treatment is important to reduce the risk of renal scarring. Rapid, cost-effective, methods of UTI diagnosis are required as an alternative to culture.

METHODS: We conducted a systematic review to determine the diagnostic accuracy of rapid tests for detecting UTI in children under five years of age.

RESULTS: The evidence supports the use of dipstick positive for both leukocyte esterase and nitrite (pooled LR+ = 28.2, 95% CI: 17.3, 46.0) or microscopy positive for both pyuria and bacteriuria (pooled LR+ = 37.0, 95% CI: 11.0, 125.9) to rule in UTI. Similarly dipstick negative for both LE and nitrite (Pooled LR- = 0.20, 95% CI: 0.16, 0.26) or microscopy negative for both pyuria and bacteriuria (Pooled LR- = 0.11, 95% CI: 0.05, 0.23) can be used to rule out UTI. A test for glucose showed promise in potty-trained children. However, all studies were over 30 years old. Further evaluation of this test may be useful.

CONCLUSION: Dipstick negative for both LE and nitrite or microscopic analysis negative for both pyuria and bacteriuria of a clean voided urine, bag, or nappy/pad specimen may reasonably be used to rule out UTI. These patients can then reasonably be excluded from further investigation, without the need for confirmatory culture. Similarly, combinations of positive tests could be used to rule in UTI, and trigger further investigation.

Original languageEnglish
Pages (from-to)4
JournalBMC Pediatrics
Volume5
Issue number1
DOIs
Publication statusPublished - 2005

Keywords

  • Child, Preschool
  • Humans
  • Infant
  • Kidney
  • Predictive Value of Tests
  • Reagent Strips
  • Urinalysis
  • Urinary Tract Infections
  • Urine

Fingerprint Dive into the research topics of 'Rapid tests and urine sampling techniques for the diagnosis of urinary tract infection (UTI) in children under five years: a systematic review'. Together they form a unique fingerprint.

Cite this