Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.
Acta Paediatr. 2010 Apr;99(4):581-4. doi: 10.1111/j.1651-2227.2009.01644.x. Epub 2010 Jan 5.
Prompt diagnosis of urinary tract infection (UTI) in children is needed to initiate treatment but is difficult to establish without urine testing, and reliance on culture leads to delay. Urine dipsticks are often used as an alternative to microscopy, although the diagnostic performance of dipsticks at different ages has not been established systematically.
Studies comparing urine dipstick testing in infants versus older children and urine dipstick versus microscopy were systematically searched and reviewed. Meta-analysis of available studies was conducted.
Six studies addressed these questions. The results of meta-analysis showed that the performance of urine dipstick testing was significantly less in the younger children when compared with older children (p < 0.01). Positive likelihood ratio (LR) of both nitrite and leucocyte positive 38.54 [95% confidence interval (CI) 22.49-65.31], negative LR for both negative 0.13 (95% CI 0.07-0.25) are reasonably good, and those for young infants are less reliable [positive LR 7.62 (95% CI 0.95-51.85) and negative LR 0.34 (95% CI 0.66-0.15)]. Comparing microscopy and urine dipstick testing, using bacterial colony count on urine culture showed no significant difference between the two methods.
Urine dipstick testing is more effective for diagnosis of UTI in children over 2 years than for younger children.
需要及时诊断儿童尿路感染（UTI）以进行治疗，但在不进行尿液检测的情况下难以确诊，而单纯依赖培养则会导致延迟。尿液试纸通常被用作显微镜检查的替代方法，尽管不同年龄段尿液试纸的诊断性能尚未得到系统确立。
系统地搜索和回顾了比较婴儿和大龄儿童尿液试纸检测以及尿液试纸与显微镜检查的研究。对现有研究进行了荟萃分析。
有 6 项研究涉及这些问题。荟萃分析的结果表明，与大龄儿童相比，年幼儿童的尿液试纸检测性能明显较差（p < 0.01）。亚硝酸盐和白细胞阳性的阳性似然比（LR）分别为 38.54（95%置信区间[CI] 22.49-65.31），两者均为阴性的 LR 为 0.13（95% CI 0.07-0.25），这两个指标的可信度较高，而对年幼婴儿的可信度较低[阳性 LR 为 7.62（95% CI 0.95-51.85），阴性 LR 为 0.34（95% CI 0.66-0.15）]。将显微镜检查和尿液试纸检测进行比较，使用尿液培养中的细菌菌落计数，两种方法之间没有显著差异。
与年幼儿童相比，尿液试纸检测对 2 岁以上儿童 UTI 的诊断更为有效。
