SynthesisBMC family practice2021
Diagnostic value of biomarkers for paediatric urinary tract infections in primary care: systematic review and meta-analysis.
Synthesis in BMC family practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 16 citations in OpenAlex.
- Role of biomarkers in pediatric sepsis: What evidence says?World journal of clinical pediatrics · 2026Review
- Predictive value of dipstick urinalysis for detecting pyelonephritis in children aged 0-12 months.Frontiers in pediatrics · 2026Article
- Association between hyponatremia and disease severity in pediatric urinary tract infections.BMC pediatrics · 2024Article
- Diffusion-weighted MRI in the identification of renal parenchymal involvement in children with a first episode of febrile urinary tract infection.Frontiers in radiology · 2024Article
- Febrile infants risk score at triage (FIRST) for the early identification of serious bacterial infections.Scientific reports · 2023Observational
- Antibiotic Use for Common Infections in Pediatric Emergency Departments: A Narrative Review.Antibiotics (Basel, Switzerland) · 2023Review
- Evaluation of new generation systemic immune-inflammation markers to predict urine culture growth in urinary tract infection in children.Frontiers in pediatrics · 2023Article
- What is the Diagnostic Accuracy of Novel Urine Biomarkers for Urinary Tract Infection?Biomarker insights · 2023Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAccurate diagnosis of urinary tract infection is essential as children left untreated may suffer permanent renal injury.
aimTo compare the diagnostic values of biomarkers or clinical prediction rules for urinary tract infections in children presenting to ambulatory care. DESIGN AND
settingSystematic review and meta-analysis of ambulatory care studies.
methodsMedline, Embase, WOS, CINAHL, Cochrane library, HTA and DARE were searched until 21 May 2021. We included diagnostic studies on urine or blood biomarkers for cystitis or pyelonephritis in children below 18 years of age. We calculated sensitivity, specificity and likelihood ratios. Data were pooled using a bivariate random effects model and a Hierarchical Summary Receiver Operating Characteristic analysis.
resultsSeventy-five moderate to high quality studies were included in this review and 54 articles in the meta-analyses. The area under the receiver-operating-characteristics curve to diagnose cystitis was 0.75 (95%CI 0.62 to 0.83, n = 9) for C-reactive protein, 0.71 (95% CI 0.62 to 0.80, n = 4) for procalcitonin, 0.93 (95% CI 0.91 to 0.96, n = 22) for the dipstick test (nitrite or leukocyte esterase ≥trace), 0.94 (95% CI 0.58 to 0.98, n = 9) for urine white blood cells and 0.98 (95% CI 0.92 to 0.99, n = 12) for Gram-stained bacteria. For pyelonephritis, C-reactive protein < 20 mg/l had LR- of 0.10 (95%CI 0.04-0.30) to 0.22 (95%CI 0.09-0.54) in children with signs suggestive of urinary tract infection.
conclusionsClinical prediction rules including the dipstick test biomarkers can support family physicians while awaiting urine culture results. CRP and PCT have low accuracy for cystitis, but might be useful for pyelonephritis.
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