Details

Autor(en) / Beteiligte

• Coulthard, Malcolm G.

Titel

Using urine nitrite sticks to test for urinary tract infection in children aged < 2 years: a meta-analysis

Ist Teil von

• Pediatric nephrology (Berlin, West), 2019-07, Vol.34 (7), p.1283-1288

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2019

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Background This study aimed to determine whether nitrite sticks are as sensitive at detecting urinary tract infection (UTI) in children <2 years as they are in older children. Methods I reanalysed data on using nitrite sticks to detect UTIs for children aged either < 2 or 2–18 years. For sensitivity, evidence of a UTI was defined as level 1 when a single uropathogen grew ≥ 10 5 colony forming units/ml (cfu/ml) in two urine samples, level 2 when just one sample was cultured or a threshold of < 10 5  cfu/ml was used, and level 3 if mixed growths or Staphylococcus albus was considered to be positive. For specificity, children were defined as uninfected if they had 1 sterile urine culture. I also reanalysed our previously published data by age. Results The sensitivity was lower for children aged < 2 years (11 studies, 1321 subjects) than for older children (9 studies, 295 subjects), whether the level-1 values or all the studies were analysed (Fisher’s exact test, p  < 0.0001 for both). The level-1 sensitivities were 0.23 in the infants and 0.81 among older children (odds ratio = 0.07, 95% confidence interval 0.03–0.18). The specificity was very high in infants (10 studies, 1783 cases) and older children (7 studies, 5952 cases), at 0.990 and 0.996. Conclusions Nitrite sticks only have a 23% sensitivity in children aged < 2 years, so cannot reliably rule out UTIs. A positive nitrite stick test is about 99% likely to indicate a UTI in children of any age.