Friday, May 29, 2015

Taking a Peek at the Accuracy of the Urinalysis for Diagnosing UTIs in Infants


By: Lewis First, MD, MS; Editor-in-Chief       

      The gold standard for diagnosis of a urinary tract infection (UTI) is the urine culture, but just how accurate is the urinalysis itself, especially in young infants?  Schroeder et al. (doi:10.1542/peds.2015-0012) tackled this question through a cross-sectional look at a cohort of 276 infants under three months of age who had a documented UTI based on a urine culture.  The authors then looked at the sensitivity and specificity of the urinalysis findings for infection.    
     More specifically, the authors report on the sensitivity of leukocyte esterase (LE) and of pyuria in the urines studied and the results may surprise you in terms of the accuracy achieved just with the urinalysis.   
     To add more import to this study, we asked Dr. Ken Roberts who chaired the AAP committee that produced the recently revised UTI guidelines to add his perspective on the findings with a commentary (doi:10.1542/peds.2015-0884) also being released this week.  
      If you wonder whether to use the urinalysis findings to help decide whether or not to get a urine culture, go with the flow and read both this study and commentary and see if you want to pay even more attention to the urinalysis results as a diagnostic indicator. 

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