Introduction: Urinary tract infection (UTI) diagnosis in infants
Patients and methods: A retrospective, cohort study, conducted between January 2015 and March 2016. Sensitivity and specificity of urine dipstick (leukocyte esterase and nitrites) for diagnosing UTI through urine culture were evaluated.
Results: Overall, 678 episodes (19% with UTI) were included. Fever was documented in 75% of the episodes. Cultures were obtained through catheter or SPA in 58% and 42% of episodes, respectively. The most common pathogen was E. coli (55%). The urine dipstick sensitivity and specificity were 51% and 95%, respectively, with similar rates in <30, 30-60 and 61-90 days old infants. Sensitivity rates were higher in episodes when SPA was used compared with catheter (67% vs. 43%, p<0.001) and when the pathogen was E.coli (66%) compared with enterococcus spp. (15%) and proteus spp. (10%). Higher leukocytes and stabs in blood count were associated with higher sensitivity rates.
Discussion: Higher sensitivity rates of the urine dipstick for UTI diagnosis were associated with SPA obtainment method, E. coli growth, and high blood leukocyte and stabs count. In contrast, the dipstick sensitivity was not associated with age. These findings can help develop new strategies for managing infants with suspected UTI.
