Sección de Urgencias de Pediatría, Departamento de Pediatría. Hospital de Cruces. Bilbao.
An Esp Pediatr. 2000 Dec;53(6):561-6.
To compare urinary gram staining and dipstick for the detection of urinary tract infection (UTI)in febrile infants.
Prospective study of 175 febrile infants aged 124 months. In all infants, a urine specimen was analyzed to detect UTI. The dipstick test was used to detect leukocytes and nitrites and samples were taken for gram staining and urine culture. Urine was obtained by urethral catheterization. Positive urine results were defined as 50.000 colony forming units per millimeter of urinary tract pathogen.
The mean age was 9.8 months (SD: 6.64). Urine culture was positive in 87 patients (49.5%). Diagnosis of UTI was confirmed in 91 patients (51.9%), of whom 74 were admitted for clinically suspected pyelonephritis (81.3%). Gram stain had the highest specificity (98.9%) and pyuria the highest sensitivity (90.8%). Better results were obtained using the combination of dipstick and Gram stain with a sensitivity of 93.1%, specificity of 98.4%, positive predictive value of 98.5% and negative predictive value of 92.5%.
Urinary Gram stain appears to be more reliable than dipstick in detecting UTI in febrile infants but the results of both tests should be interpreted together.
比较尿革兰氏染色和试纸条法在检测发热婴儿尿路感染（UTI）中的应用。
对175名年龄在1 - 24个月的发热婴儿进行前瞻性研究。对所有婴儿的尿液标本进行分析以检测UTI。使用试纸条法检测白细胞和亚硝酸盐，并采集样本进行革兰氏染色和尿培养。通过尿道插管获取尿液。尿培养阳性结果定义为每毫升尿液中尿路病原体菌落形成单位达50,000个。
平均年龄为9.8个月（标准差：6.64）。87例患者（49.5%）尿培养呈阳性。91例患者（51.9%）确诊为UTI，其中74例因临床疑似肾盂肾炎入院（81.3%）。革兰氏染色特异性最高（98.9%），脓尿敏感性最高（90.8%）。试纸条法和革兰氏染色联合使用效果更佳，敏感性为93.1%，特异性为98.4%，阳性预测值为98.5%，阴性预测值为92.5%。
在检测发热婴儿UTI方面，尿革兰氏染色似乎比试纸条法更可靠，但两种检测结果应综合解读。
