Is culture-positive urinary tract infection in febrile children accurately identified by urine dipstick or microanalysis?
BACKGROUND
Fever from a urinary tract source remains the predominant etiology of serious bacterial infection in children ages 0-36 months. Urine culture is the gold standard for diagnosing a urinary tract infection (UTI); however, urine dipstick (UDip) and urine microanalysis (UA) are typically used real time by Emergency Physicians to diagnose and treat UTIs, as cultures can take days to grow and be available. The purpose of this article is to evaluate the literature on the accuracy and utility of the UDip and UA in this pediatric population.


METHODS
A structured review of the medical literature to determine the accuracy of UDip and UA for the diagnosis of UTI in children before the result of the urine culture.


RESULTS
Upon comprehensive review and after applying predefined inclusion criteria, a total of 13 articles met inclusion criteria, addressed the clinical question, and were reviewed in detail.


CONCLUSIONS
The literature search did not conclusively identify any component of either the UDip or the UA, which would allow a practitioner to conclude definitively that the source of an infant's fever is a UTI.
University of Maryland School of Medicine, Baltimore, Maryland; Franklin Square Hospital Center, Baltimore, Maryland, USA.
Jack
J
Perkins
Karen
K
Perkins
Gary M
GM
Vilke
Faisal Y
FY
Almazroua
D002648:Child; D005334:Fever / Q000150:complications*; D006801:Humans; D011934:Reagent Strips; D016482:Urinalysis / Q000379:methods; D014552:Urinary Tract Infections / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D014556:Urine / Q000382:microbiology
D011934:Reagent Strips