Evidence map›Paper›PMID 39563499›Full record

ArticlePediatrics2024

Accuracy of Screening Tests for the Diagnosis of Urinary Tract Infections in Young Children.

Nader Shaikh, Elizabeth A Campbell, Calise Curry, Caitlin Mickles, Elisabeth B Cole, Hui Liu, Matthew C Lee, Isabella O Conway, Grace D Mueller, Asumi Gibeau and 7 more

Abstract readComparative StudyMulticenter Study
In one paragraph

Article in Pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Urinary tract infections in children.Nature reviews. Urology · 2026
    Review
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Nader ShaikhDivision of General Academic Pediatrics, University of Pittsburgh School of Medicine.
Elizabeth A CampbellDivision of General Academic Pediatrics, University of Pittsburgh School of Medicine.
Calise CurryDivision of Hospital Medicine, University of Cincinnati College of Medicine, Cincinnati Children's Hospital, Cincinnati, Ohio.
Caitlin MicklesDivision of General Academic Pediatrics, University of Pittsburgh School of Medicine.
Elisabeth B ColeDivision of General Academic Pediatrics, University of Pittsburgh School of Medicine.
Hui LiuDivision of General Academic Pediatrics, University of Pittsburgh School of Medicine.
Matthew C LeeDivision of General Academic Pediatrics, University of Pittsburgh School of Medicine.
Isabella O ConwayDivision of General Academic Pediatrics, University of Pittsburgh School of Medicine.
Grace D MuellerDivision of General Academic Pediatrics, University of Pittsburgh School of Medicine.
Asumi GibeauDivision of General Academic Pediatrics, University of Pittsburgh School of Medicine.
Patrick W BradyDivision of Hospital Medicine, University of Cincinnati College of Medicine, Cincinnati Children's Hospital, Cincinnati, Ohio.
Jayne RasmussenClinical Laboratory, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania.
Mark KohlheppClinical Laboratory, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania.
Heba QureiniDivision of General Academic Pediatrics, University of Pittsburgh School of Medicine.
Marva Moxey-MimsDivision of Nephrology, Department of Pediatrics, Children's National Hospital, The George Washington University School of Medicine, Washington, District of Columbia.
Whitney WilliamsDivision of Nephrology, Department of Pediatrics, Children's National Hospital, The George Washington University School of Medicine, Washington, District of Columbia.
Stephanie Davis-RodriguezDivision of Hospital Medicine, University of Cincinnati College of Medicine, Cincinnati Children's Hospital, Cincinnati, Ohio.

Funding

Biomarkers for Urinary Tract Infection and PyelonephritisR01DK118033 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SHAIKH, NADER · 2019 to 2024
$2.7M
NIDDK NIH HHS R01 DK118033
6 · The paper itself

Abstract

backgroundThe objective of this study was to compare the accuracy of available tests for pyuria, including newer automated tests, and to examine the implications of requiring them for the diagnosis of urinary tract infections (UTIs).

methodsWe included children between 1 and 36 months of age undergoing bladder catheterization for suspected UTIs who presented to 1 of 3 pediatric centers. Using a positive urine culture result as the reference standard, we compared the sensitivity of 5 modalities for assessing pyuria at the cutoffs most often used clinically for detecting children with a positive culture result: leukocyte esterase on a dipstick, white blood cell (WBC) count on manual microscopy with and without using a hemocytometer, automated WBC enumeration using flow cytometry, and automated WBC enumeration using digital imaging with particle recognition.

resultsA total of 4188 children were included. Among febrile children, the sensitivity of the 2 most widely available modalities, the leukocyte esterase test and WBC enumeration using digital imaging, had sensitivity values of 84% (95% confidence interval, 0.80-0.87) and 75% (95% confidence interval, 0.66-0.83), respectively.

conclusionsOur findings suggest that for febrile children <36 months of age undergoing bladder catheterization for suspected UTI, pyuria will be absent in ∼20% of children who are eventually shown to have pure growth of a pathogen on a culture. This raises questions about the appropriateness of requiring pyuria for the diagnosis of UTIs.

Indexed as

PyuriaSensitivity and SpecificityUrinary Tract InfectionsCarboxylic Ester HydrolasesChild, PreschoolFemaleFlow CytometryHumansInfantLeukocyte CountMaleUrinalysisUrinary CatheterizationCarboxylic Ester Hydrolasesleukocyte esterase

Identifiers

PMID39563499
PMCPMC11614154

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.