Document Detail

Urinalysis is not reliable to detect a urinary tract infection in febrile infants presenting to the ED.
MedLine Citation:
PMID:  19857409     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Urinary tract infections are a common source of serious bacterial infections in febrile infants younger than 2 years. Our objective was to compare urinalysis with urine culture in the emergency department evaluation of febrile infants. METHODS: A febrile infant registry was instituted at a tertiary care hospital treating an average of 55000 patients annually (27% children), from December 2002 to December 2003. Patients were eligible if they were younger than 3 months and had a temperature of at least 38 degrees C or if they were between 3 and 24 months of age and had a temperature of at least 39 degrees C. Data abstracted included age, sex, and temperature. Urinalysis (UA) and urine culture (UCx) results were obtained from electronic hospital archives. RESULTS: Nine hundred eighty-five patients were entered into the febrile infant registry. Male patients comprised 55%. The mean age of patients was 12.6 months; median was 12 months. Four hundred thirty-five (78% of eligible patients) had both a UA and UCx from the same specimen, and there were 45 (10.3%) positive UCx result. Females accounted for 33 (73%) of 45 positive results. The sensitivity of UA for predicting a positive UCx result was 64% (95% confidence interval [CI], 49%-78%), whereas the specificity was 91% (95% CI, 88%-94%). The positive predictive value was 46% (95% CI, 31%-53%), with a negative predictive value of 96% (95% CI, 93%-97%). CONCLUSION: Urinalysis is not reliable for the detection of urinary tract infections in febrile infants when compared with urine cultures.
Jacqueline M Reardon; Keri L Carstairs; Sherri L Rudinsky; Leslie V Simon; Robert H Riffenburgh; David A Tanen
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  27     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-27     Completed Date:  2009-12-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  930-2     Citation Subset:  IM    
Department of Emergency Medicine, Naval Medical Center San Diego, CA 92134, USA.
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MeSH Terms
Diagnosis, Differential
Emergency Service, Hospital*
Predictive Value of Tests
Urinary Tract Infections / diagnosis*
Urine / microbiology*

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