Test characteristics of tests used to diagnose urinary tract infections in children

	Sensitivity	Specificity	Positive likelihood ratio*	Negative likelihood ratio^¶
Dipstick
LE	84%	78%	4	0.2
Nitrite	50%	98%	25	0.5
Nitrite or LE	88%	93%	13	0.1
Nitrite and LE	72%	96%	18	0.3
Microscopy
Uncentrifuged
Pyuria (>10/mm³) (all ages)	77%	89%	7	0.4
Pyuria (>10/mm³) (<2 years)	90%	95%	18	0.1
Bacteriuria (Gram-stained)	93%	95%	19	0.1
Overall (P+B) = enhanced	85%	99.9%	85	0.1
Overall (P or B)	95%	89%	9	0.1
Centrifuged
Pyuria (>5/hpf)	67%	79%	3	0.4
Bacteriuria	81%	83%	5	0.2
Overall (P+B)	66%	99%	7	0.4

LE: leukocyte esterase; P: pyuria; B: bacteriuria; hpf: high-power field.
* Positive likelihood ratio: The positive likelihood ratio is the probability that a child with a UTI will have a positive test divided by the probability that a child without a UTI will have a positive test (eg, true positive rate/false positive rate). The higher the positive likelihood ratio, the better the test.
¶ Negative likelihood ratio: The negative likelihood ratio is the probability that a child with a UTI will have a negative test divided by the probability that a child without a UTI will have a negative test (eg, false negative rate/true negative rate). The lower the negative likelihood ratio, the better the test (a perfect test has a negative likelihood ratio of zero).

References:

Gorelick MH, Shaw KN. Screening tests for urinary tract infection in children: A meta-analysis. Pediatrics 1999; 104:e54.
Huicho L, Campos-Sanchez M, Alamo C. Metaanalysis of urine screening tests for determining the risk of urinary tract infection in children. Pediatr Infect Dis J 2002; 21:1.
Finnell SM, Carroll AE, Downs SM, the Subcommittee on Urinary Tract Infection. Technical report--Diagnosis and management of an initial UTI in febrile infants and young children. Pediatrics 2011; 128:e749.

Graphic 82157 Version 11.0

خرید پکیج

Test characteristics of tests used to diagnose urinary tract infections in children