Development of a Score Based on Urinalysis to Improve the Management of Urinary Tract Infection in Children

Mohamed Hamed Bahbah; Ahmed Anower Khattab; Rania Salah El Zayat; Abdelwahab Mohamed Badr

doi:doi:10.11648/j.ajbio.20150301.11

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Development of a Score Based on Urinalysis to Improve the Management of Urinary Tract Infection in Children

Mohamed Hamed Bahbah, Ahmed Anower Khattab, Rania Salah El Zayat, Abdelwahab Mohamed Badr

Published in American Journal of BioScience (Volume 3, Issue 1)

Received: 12 December 2014 Accepted: 23 December 2014 Published: 31 December 2014

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Abstract

Objectives: Our aim is to develop a score that may help in reducing the misuse of antibiotics in treatment of urinary tract infection before appearance of urine culture. Background: The need for reducing unnecessary antibiotic treatment is being emphasized in the management of urinary tract infections (UTI), a disease frequent in childhood. An ideal test should provide early diagnosis without the waiting times of urine culture, but even a simple test of exclusion could significantly improve patient management. Methods: We evaluated the sensitivity, specificity, negative and positive predictive value of urine analysis, dipstick (leukocyte esterase and nitrite) and bacterial colony count in children with suspected UTI. Multivariable logistic regression analysis was used to identify the set of variables that best predict positive culture results and develop a numerical risk score. Results: Of 200 children were having symptoms of UTI, 93 child had confirmed UTI with prevalence 46.5%. Parameters significantly associated with the presence of infection in multivariable analysis were age 9-12 years (p < 0.05), leukocyte esterase positive (p < 0.001), nitrite positive (p < 0.05), pus cell >10/HPF (p < 0.05), RBCs>10/HPF (p < 0.05) and bacteria ≥ 10^6 (p < 0.05).The derived score ranged from 1 to 7, with higher values indicating higher risk of UTI. Conclusion: This routine method could improve the management of UTI in children by early identifying patients with low probability of infection, for which antibiotic treatment can be withheld until the results of urine culture become available.

Published in	American Journal of BioScience (Volume 3, Issue 1)
DOI	10.11648/j.ajbio.20150301.11
Page(s)	1-6
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

Urinary Tract Infection, Urinalysis

References

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[4]	Brett White. (2011): Diagnosis and Treatment of Urinary Tract Infections in Children Oregon Health and Science University, Portland, Oregon Am Fam Physician. Feb 15; 83(4):409-415.
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[7]	Heffner, V., Gorelick, M (2008): Pediatric Urinary Tract Infection. ClinPedEmerg Med.; 9: 233-237.
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[17]	Pagana KD and Pagana TJ (2010): Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier, 700-701.
[18]	Rosa L., Simone P., Leonardo F., Marta A., Francesca F., Marina C., Emilia M., Francesco E. and Maurizio M. (2011): Development of a score based on urinalysis to improve the management of urinary tract infection in children. ClinicaChimicaActa Volume 413: 3–4, 18 February, 478–482.
[19]	Stanley R, Pagon Z and Bachur R. (2005): Hyperpyrexia among infants younger than 3 months.Pediatric Emergency, 21(5):291-4.
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APA Style

Mohamed Hamed Bahbah, Ahmed Anower Khattab, Rania Salah El Zayat, Abdelwahab Mohamed Badr. (2014). Development of a Score Based on Urinalysis to Improve the Management of Urinary Tract Infection in Children. American Journal of BioScience, 3(1), 1-6. https://doi.org/10.11648/j.ajbio.20150301.11

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ACS Style

Mohamed Hamed Bahbah; Ahmed Anower Khattab; Rania Salah El Zayat; Abdelwahab Mohamed Badr. Development of a Score Based on Urinalysis to Improve the Management of Urinary Tract Infection in Children. Am. J. BioScience 2014, 3(1), 1-6. doi: 10.11648/j.ajbio.20150301.11

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AMA Style

Mohamed Hamed Bahbah, Ahmed Anower Khattab, Rania Salah El Zayat, Abdelwahab Mohamed Badr. Development of a Score Based on Urinalysis to Improve the Management of Urinary Tract Infection in Children. Am J BioScience. 2014;3(1):1-6. doi: 10.11648/j.ajbio.20150301.11

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@article{10.11648/j.ajbio.20150301.11,
  author = {Mohamed Hamed Bahbah and Ahmed Anower Khattab and Rania Salah El Zayat and Abdelwahab Mohamed Badr},
  title = {Development of a Score Based on Urinalysis to Improve the Management of Urinary Tract Infection in Children},
  journal = {American Journal of BioScience},
  volume = {3},
  number = {1},
  pages = {1-6},
  doi = {10.11648/j.ajbio.20150301.11},
  url = {https://doi.org/10.11648/j.ajbio.20150301.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajbio.20150301.11},
  abstract = {Objectives: Our aim is to develop a score that may help in reducing the misuse of antibiotics in treatment of urinary tract infection before appearance of urine culture. Background: The need for reducing unnecessary antibiotic treatment is being emphasized in the management of urinary tract infections (UTI), a disease frequent in childhood. An ideal test should provide early diagnosis without the waiting times of urine culture, but even a simple test of exclusion could significantly improve patient management. Methods: We evaluated the sensitivity, specificity, negative and positive predictive value of urine analysis, dipstick (leukocyte esterase and nitrite) and bacterial colony count in children with suspected UTI. Multivariable logistic regression analysis was used to identify the set of variables that best predict positive culture results and develop a numerical risk score. Results: Of 200 children were having symptoms of UTI, 93 child had confirmed UTI with prevalence 46.5%. Parameters significantly associated with the presence of infection in multivariable analysis were age 9-12 years (p 10/HPF (p 10/HPF (p < 0.05) and bacteria ≥ 10^6 (p < 0.05).The derived score ranged from 1 to 7, with higher values indicating higher risk of UTI. Conclusion: This routine method could improve the management of UTI in children by early identifying patients with low probability of infection, for which antibiotic treatment can be withheld until the results of urine culture become available.},
 year = {2014}
}

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TY  - JOUR
T1  - Development of a Score Based on Urinalysis to Improve the Management of Urinary Tract Infection in Children
AU  - Mohamed Hamed Bahbah
AU  - Ahmed Anower Khattab
AU  - Rania Salah El Zayat
AU  - Abdelwahab Mohamed Badr
Y1  - 2014/12/31
PY  - 2014
N1  - https://doi.org/10.11648/j.ajbio.20150301.11
DO  - 10.11648/j.ajbio.20150301.11
T2  - American Journal of BioScience
JF  - American Journal of BioScience
JO  - American Journal of BioScience
SP  - 1
EP  - 6
PB  - Science Publishing Group
SN  - 2330-0167
UR  - https://doi.org/10.11648/j.ajbio.20150301.11
AB  - Objectives: Our aim is to develop a score that may help in reducing the misuse of antibiotics in treatment of urinary tract infection before appearance of urine culture. Background: The need for reducing unnecessary antibiotic treatment is being emphasized in the management of urinary tract infections (UTI), a disease frequent in childhood. An ideal test should provide early diagnosis without the waiting times of urine culture, but even a simple test of exclusion could significantly improve patient management. Methods: We evaluated the sensitivity, specificity, negative and positive predictive value of urine analysis, dipstick (leukocyte esterase and nitrite) and bacterial colony count in children with suspected UTI. Multivariable logistic regression analysis was used to identify the set of variables that best predict positive culture results and develop a numerical risk score. Results: Of 200 children were having symptoms of UTI, 93 child had confirmed UTI with prevalence 46.5%. Parameters significantly associated with the presence of infection in multivariable analysis were age 9-12 years (p 10/HPF (p 10/HPF (p < 0.05) and bacteria ≥ 10^6 (p < 0.05).The derived score ranged from 1 to 7, with higher values indicating higher risk of UTI. Conclusion: This routine method could improve the management of UTI in children by early identifying patients with low probability of infection, for which antibiotic treatment can be withheld until the results of urine culture become available.
VL  - 3
IS  - 1
ER  -

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Author Information

Mohamed Hamed Bahbah

Pediatrics department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt
Ahmed Anower Khattab

Pediatrics department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt
Rania Salah El Zayat

Pediatrics department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt
Abdelwahab Mohamed Badr

Pediatrics department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt

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APA Style

Mohamed Hamed Bahbah, Ahmed Anower Khattab, Rania Salah El Zayat, Abdelwahab Mohamed Badr. (2014). Development of a Score Based on Urinalysis to Improve the Management of Urinary Tract Infection in Children. American Journal of BioScience, 3(1), 1-6. https://doi.org/10.11648/j.ajbio.20150301.11

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ACS Style

Mohamed Hamed Bahbah; Ahmed Anower Khattab; Rania Salah El Zayat; Abdelwahab Mohamed Badr. Development of a Score Based on Urinalysis to Improve the Management of Urinary Tract Infection in Children. Am. J. BioScience 2014, 3(1), 1-6. doi: 10.11648/j.ajbio.20150301.11

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AMA Style

Mohamed Hamed Bahbah, Ahmed Anower Khattab, Rania Salah El Zayat, Abdelwahab Mohamed Badr. Development of a Score Based on Urinalysis to Improve the Management of Urinary Tract Infection in Children. Am J BioScience. 2014;3(1):1-6. doi: 10.11648/j.ajbio.20150301.11

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@article{10.11648/j.ajbio.20150301.11,
  author = {Mohamed Hamed Bahbah and Ahmed Anower Khattab and Rania Salah El Zayat and Abdelwahab Mohamed Badr},
  title = {Development of a Score Based on Urinalysis to Improve the Management of Urinary Tract Infection in Children},
  journal = {American Journal of BioScience},
  volume = {3},
  number = {1},
  pages = {1-6},
  doi = {10.11648/j.ajbio.20150301.11},
  url = {https://doi.org/10.11648/j.ajbio.20150301.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajbio.20150301.11},
  abstract = {Objectives: Our aim is to develop a score that may help in reducing the misuse of antibiotics in treatment of urinary tract infection before appearance of urine culture. Background: The need for reducing unnecessary antibiotic treatment is being emphasized in the management of urinary tract infections (UTI), a disease frequent in childhood. An ideal test should provide early diagnosis without the waiting times of urine culture, but even a simple test of exclusion could significantly improve patient management. Methods: We evaluated the sensitivity, specificity, negative and positive predictive value of urine analysis, dipstick (leukocyte esterase and nitrite) and bacterial colony count in children with suspected UTI. Multivariable logistic regression analysis was used to identify the set of variables that best predict positive culture results and develop a numerical risk score. Results: Of 200 children were having symptoms of UTI, 93 child had confirmed UTI with prevalence 46.5%. Parameters significantly associated with the presence of infection in multivariable analysis were age 9-12 years (p 10/HPF (p 10/HPF (p < 0.05) and bacteria ≥ 10^6 (p < 0.05).The derived score ranged from 1 to 7, with higher values indicating higher risk of UTI. Conclusion: This routine method could improve the management of UTI in children by early identifying patients with low probability of infection, for which antibiotic treatment can be withheld until the results of urine culture become available.},
 year = {2014}
}

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TY  - JOUR
T1  - Development of a Score Based on Urinalysis to Improve the Management of Urinary Tract Infection in Children
AU  - Mohamed Hamed Bahbah
AU  - Ahmed Anower Khattab
AU  - Rania Salah El Zayat
AU  - Abdelwahab Mohamed Badr
Y1  - 2014/12/31
PY  - 2014
N1  - https://doi.org/10.11648/j.ajbio.20150301.11
DO  - 10.11648/j.ajbio.20150301.11
T2  - American Journal of BioScience
JF  - American Journal of BioScience
JO  - American Journal of BioScience
SP  - 1
EP  - 6
PB  - Science Publishing Group
SN  - 2330-0167
UR  - https://doi.org/10.11648/j.ajbio.20150301.11
AB  - Objectives: Our aim is to develop a score that may help in reducing the misuse of antibiotics in treatment of urinary tract infection before appearance of urine culture. Background: The need for reducing unnecessary antibiotic treatment is being emphasized in the management of urinary tract infections (UTI), a disease frequent in childhood. An ideal test should provide early diagnosis without the waiting times of urine culture, but even a simple test of exclusion could significantly improve patient management. Methods: We evaluated the sensitivity, specificity, negative and positive predictive value of urine analysis, dipstick (leukocyte esterase and nitrite) and bacterial colony count in children with suspected UTI. Multivariable logistic regression analysis was used to identify the set of variables that best predict positive culture results and develop a numerical risk score. Results: Of 200 children were having symptoms of UTI, 93 child had confirmed UTI with prevalence 46.5%. Parameters significantly associated with the presence of infection in multivariable analysis were age 9-12 years (p 10/HPF (p 10/HPF (p < 0.05) and bacteria ≥ 10^6 (p < 0.05).The derived score ranged from 1 to 7, with higher values indicating higher risk of UTI. Conclusion: This routine method could improve the management of UTI in children by early identifying patients with low probability of infection, for which antibiotic treatment can be withheld until the results of urine culture become available.
VL  - 3
IS  - 1
ER  -

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