ArticlePediatrics international : official journal of the Japan Pediatric Society
Urinalysis Abnormalities and Culture Positivity in Children With Clean Intermittent Catheterization.
Article in Pediatrics international : official journal of the Japan Pediatric Society. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDiagnosis of urinary tract infection (UTI) in children with neurogenic bladder is challenging due to frequent bacterial colonization and unreliable symptom assessment. This study aimed to evaluate the diagnostic performance of urinalysis parameters in predicting urine culture positivity in children undergoing clean intermittent catheterization (CIC).
methodsWe retrospectively analyzed urine samples from children with neurogenic bladder who underwent CIC between 2015 and 2024. All samples were included regardless of symptom status. Urinalysis parameters, including leukocyte esterase (LE), nitrite, pyuria, and bacteriuria, were evaluated. Culture positivity was defined as growth of a single organism ≥ 10
resultsA total of 1362 urine samples from 107 patients were analyzed. The combination "Nitrite OR Bacteriuria" achieved the highest AUC (0.84), with sensitivity 0.85, specificity 0.84, PPV 0.84, NPV 0.85, and NLR 0.18. The three-parameter combination "LE OR Nitrite OR Bacteriuria" showed the highest sensitivity (0.94) and NPV (0.92), with an NLR of 0.10 indicating strong rule-out potential. Among AND-rule combinations, "LE AND Nitrite" showed the highest specificity (0.98) and PPV (0.93; PLR 14.27), but low sensitivity (0.36).
conclusionsUrinalysis parameter combinations may help predict urine culture positivity (≥ 10
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