[Microbiological diagnosis of urinary tract infections in the child. Importance of rapid tests].
Urine collection study is one of the most common means of bacteriological diagnosis in the laboratory. However, numerous interpretation problems exist. The aim of this paper is to specify these problems and to indicate the place of rapid tests in the screening for urinary tract infection. Direct examination must be performed on rapidly collected and transported urine. In such conditions, absence or presence of both leukocytes or germs presents a good negative or positive predictive value. However, false positive leukocyturia is frequent. False positive bacteriuria is mostly due to bad collection or transport. In some cases the threshold of bacteriuria > or = 10(5) cfu/mL can be reduced. Rapid tests include leukocyte esterase and nitrite tests. In our study, recording 289 tests, we observed negative and positive predictive values of respectively, 92% and 100% when the two tests were used together. Dipsticks can be used to exclude a urinary tract infection when clinical symptoms are absent, but only if they are used correctly. When both tests are positive, a urinary tract infection is likely. Study on urine collection is difficult in children. Collaboration between clinician and bacteriologist is essential.
Service microbiologie, hôpital Saint-Vincent-de-Paul, Paris, France.
J
J
Raymond
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C
Sauvestre
D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology; D001431:Bacteriological Techniques; D001437:Bacteriuria / Q000175:diagnosis / Q000382:microbiology; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010348:Patient Care Team; D011237:Predictive Value of Tests; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000382:microbiology
Diagnostic microbiologique des infections urinaires chez l'enfant. Intérêt des tests rapides.