title: Optical diagnosis of lower urinary tract infection: a pilot study in children.
abstract: Conventionally, diagnosis of lower urinary tract infection (LUTI) is made on the basis of history, urine microscopy and culture. But there are limitations to this methodology especially in children and special populations where there is difficulty in obtaining a full history and details of clinical symptoms. The aim of this study was to determine if monitoring bladder wall oxygenation as a measure of bladder mucosal inflammation using transcutaneous near-infrared spectroscopy (NIRS) allows detection of the presence or absence of LUTI in children.
  
  
  METHODS
  A convenience sample of children referred to a pediatric urology clinic with an acute LUTI and a control group were studied. Diagnosis was confirmed by history, physical examination, laboratory investigations, and urine culture. Participants had transcutaneous measurement of an absolute measure of tissue oxygen saturation (TSI%) in their bladder wall, and a quadriceps muscle control site, using a spatially resolved (SR) wireless NIRS device. Average measures of bladder wall TSI% (B.TSI%) and quadriceps TSI% (Q.TSI%) and their differences (TSI.diff) were calculated and compared between those with LUTI and controls by performing a two-way repeated analysis of variance.
  
  
  RESULTS
  Thirty-four patients met the inclusion criteria (LUTI n = 12 and controls n = 22). Comparing LUTI to controls B.TSI% and TSI.diff values were significantly higher in the LUTI group (p < 0.0001), while Q.TSI% values were not significantly different.
  
  
  CONCLUSIONS
  Optical monitoring of bladder wall oxygenation is feasible in children. In this study a significant difference was evident in a SR NIRS-derived measure of absolute oxygen saturation in the bladder wall between children with UTI diagnosed by conventional testing methods, and those in a control group without infection. SR-NIRS monitoring of bladder wall oxygenation may offer a rapid and non-invasive means of bedside screening for LUTI where history and/or clinical signs are not available or adequate.
authors: Department of Urologic Sciences, University of British Columbia, Vancouver, Canada; Center for International Collaboration on Repair Discoveries (ICORD), Vancouver, Canada. Electronic address: shadgan@alumni.ubc.ca.
authors: Babak
authors: B
authors: Shadgan
authors: Department of Urologic Sciences, University of British Columbia, Vancouver, Canada; Center for International Collaboration on Repair Discoveries (ICORD), Vancouver, Canada. Electronic address: nigro@mail.ubc.ca.
authors: Mark
authors: M
authors: Nigro
authors: Department of Urologic Sciences, University of British Columbia, Vancouver, Canada. Electronic address: ajmacnab@gmail.com.
authors: Andrew
authors: A
authors: Macnab
authors: Pediatric Urology Research Center, Children's Hospital Medical Center, Tehran University of Medical Sciences, Iran. Electronic address: dr.fareghi@yahoo.com.
authors: Mehdi
authors: M
authors: Fareghi
authors: Department of Urologic Sciences, University of British Columbia, Vancouver, Canada; Center for International Collaboration on Repair Discoveries (ICORD), Vancouver, Canada. Electronic address: lynns@mail.ubc.ca.
authors: Lynn
authors: L
authors: Stothers
authors: Pediatric Urology Research Center, Children's Hospital Medical Center, Tehran University of Medical Sciences, Iran. Electronic address: lidasharifirad@gmail.com.
authors: Lida
authors: L
authors: Sharifi-Rad
authors: Pediatric Urology Research Center, Children's Hospital Medical Center, Tehran University of Medical Sciences, Iran. Electronic address: kajbafzd@sina.tums.ac.ir.
authors: Abdol-Mohammad
authors: AM
authors: Kajbafzadeh
mesh_terms: D000367:Age Factors; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003556:Cystitis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000379:methods; D010100:Oxygen / Q000378:metabolism; D010865:Pilot Projects; D012039:Regional Blood Flow / Q000502:physiology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D016482:Urinalysis; D014552:Urinary Tract Infections / Q000175:diagnosis*; D014556:Urine / Q000382:microbiology
chemical_list: D010100:Oxygen
keywords: Cystitis; Infection; Inflammation; Near-infrared spectroscopy; Urinary bladder