SynthesisAnnals of family medicine
Clinical Features for the Diagnosis of Pediatric Urinary Tract Infections: Systematic Review and Meta-Analysis.
Synthesis in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Prevalence and determinants of urinary tract infection among Ethiopian children: a systematic review and meta-analysis of institution-based studies.BMC infectious diseases · 2026Pooled it
- Urological Malformations Identify the High-Burden Phenotype Among Children Hospitalized for Presumed Urinary Tract Infection: A Retrospective Cohort.Diagnostics (Basel, Switzerland) · 2026Article
- Diagnosing Urinary Tract Infection in Young Febrile Children in the Emergency Department.JAMA network open · 2026Article
- Usefulness of Enhanced Urine Analysis in Febrile Urinary Tract Infection.Journal of pharmacy & bioallied sciences · 2025Article
- Urine Testing in Children with Viral Symptoms: A Nationwide Analysis of Ambulatory Visits, 2014-2019.The Journal of pediatrics · 2025Article
- Improving the diagnosis of urinary tract infections by the use of enriched media and a 48-hour incubation period.Journal of medical microbiology · 2024Article
- Noninferiority of Multiplex Polymerase Chain Reaction Compared to Standard Urine Culture for Urinary Tract Infection Diagnosis in Pediatric Patients at Hackensack Meridian Health Children's Hospital Emergency Department.Pediatric health, medicine and therapeutics · 2024Article
- Incidence rates and trends of childhood urinary tract infections and antibiotic prescribing: registry-based study in general practices (2000 to 2020).BMC primary care · 2022Article
- Clinical prediction rules for childhood urinary tract infections: a cross-sectional study in ambulatory care.BJGP open · 2022Article
- GPs' perspectives on diagnosing childhood urinary tract infections: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Management of antibacterial therapy of infectious and inflammatory diseases of the urinary tract in children and regional peculiarities during the COVID-19 pandemic.Journal of medicine and life · 2022Article
- Pediatric kidney transplant recipients with and without underlying structural kidney disease have a comparable risk of hospitalization associated with urinary tract infections.Frontiers in pediatrics · 2022Article
- Design and Optimization of Urinary Real-Time Nursing Model Based on Medical Internet of Things.Computational intelligence and neuroscience · 2022Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAccurate diagnosis of urinary tract infection in children is essential because children left untreated can experience permanent renal injury. We aimed to assess the diagnostic value of clinical features of pediatric urinary tract infection.
methodsWe performed a systematic review and meta-analysis of diagnostic test accuracy studies in ambulatory care. We searched the PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Health Technology Assessment, and Database of Abstracts of Reviews of Effects databases from inception to January 27, 2020 for studies reporting 2 × 2 diagnostic accuracy data for clinical features compared with urine culture in children aged <18 years. For each clinical feature, we calculated likelihood ratios and posttest probabilities of urinary tract infection. To estimate summary parameters, we conducted a bivariate random effects meta-analysis and hierarchical summary receiver operating characteristic analysis.
resultsA total of 35 studies (N = 78,427 patients) of moderate to high quality were included, providing information on 58 clinical features and 6 prediction rules. Only circumcision (negative likelihood ratio [LR-] 0.24; 95% CI, 0.08-0.72; n = 8), stridor (LR- 0.20; 95% CI, 0.05-0.81; n = 1), and diaper rash (LR- 0.13; 95% CI, 0.02-0.92; n = 1) were useful for ruling out urinary tract infection. Body temperature or fever duration showed limited diagnostic value (area under the receiver operating characteristic curve 0.61; 95% CI, 0.47-0.73; n = 16). The Diagnosis of Urinary Tract Infection in Young Children score, Gorelick Scale score, and UTIcalc (https://uticalc.pitt.edu) might be useful to identify children eligible for urine sampling.
conclusionsFew clinical signs and symptoms are useful for diagnosing or ruling out urinary tract infection in children. Clinical prediction rules might be more accurate; however, they should be validated externally. Physicians should not restrict urine sampling to children with unexplained fever or other features suggestive of urinary tract infection.
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