ABSTRACT 842
Bildiriler > Özet Bildiri
Yazarlar: Eylem Ulaş SAZ, HAMİYET HEKİMCİ ÖZDEMİR, H. Hortu, A.M. Ulusan
Pediatric Critical Care Medicine, , , Uluslararası, Özet Bildiri, Wos, cilt 15, ss 187-188
DOI: 10.1097/01.pcc.0000449568.10210.0f
Özet
Background and aims: Urinary tract infections are a common source of bacterial infection among young febrile children. Aims: To determine whether the negative urinalysis (UA) can be used to eliminate the diagnosis of urinary tract infection to determine the situations that necessitate the urine culture regardless of the UA result. Methods: Retrospective medical record review of patients aged 3–36 months with fever or other nonspecific symptoms (irritability, vomiting, diarrhea, and poor feeding) seen in the emergency department during a period of 6 months. Cultures were obtained by bag reviewed, isolates, and colony counts. A UA result was considered positive if the presence of 1 of the following was detected: nitrite, or pyuria-hematuria (≥5 white or red blood cells per high power field), bacteriuria. Patients who had a paired UA and urine culture were used to calculate the sensitivity, specificity, and likelihood ratios of the UA. Results: Medical records of 307 eligible children were reviewed. Fifty-four percent were girls. Median age and temperature were 13 months and 38.9°C. The sensitivity of the UA was 66.6% (95% confidence interval [CI], 56%-75%). The specificity of UA was 58.7% (95% CI, 49%-67%). The likelihood ratios for a positive UA and negative UA were 1.6 (95% CI, 1.26–2.06) and 0.56(95% CI, 0.42–0.75), respectively. Around 30% of patients with negative UA had positive urine culture, and they evaluated by other laboratory tests. Contamination and hopitalization rate was 35.6%, 4% respectively. Conclusions: UA obtained by bag for the presence of significant pyuria cannot be used to guide decisions regarding the need for urine culture in young symptomatic children.