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

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Whiting, Penny, Westwood, Marie, Watt, Ian, Cooper, Julie, Kleijnen, Jos·2005·BMC Pediatrics
DOI 10.1186/1471-2431-5-4
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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.

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Metadata

Authors
Whiting, P., Westwood, M., Watt, I., Cooper, J., & Kleijnen, J.
Venue
BMC Pediatrics
Publisher
Springer Science and Business Media LLC
Published
2005-04-05
Volume
5
Issue
1
Pages
4-4
ISSN
1471-2431 (ISSN-L)
DOI
10.1186/1471-2431-5-4
OpenAlex
W1723359935
Cited by
164
References
2
FWCI
0.85
Type
journal article
Language
en
Open access
gold
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Whiting, P., Westwood, M., Watt, I., Cooper, J., & Kleijnen, J. (2005). Rapid tests and urine sampling techniques for the diagnosis of urinary tract infection (UTI) in children under five years: a systematic review. BMC Pediatrics. https://doi.org/10.1186/1471-2431-5-4

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