Department of Pediatrics, National Hospital Organization Saitama Hospital, Saitama, Japan.
Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.
Sci Rep. 2020 Nov 9;10(1):19342. doi: 10.1038/s41598-020-76405-7.
Urinary tract infection (UTI) is one of the most common bacterial infections in children. The symptoms of UTI in young children are nonspecific, therefore urine should be examined whenever UTI cannot be ruled out. In clinical settings, however, collecting urine from children who are not toilet trained is sometimes difficult, presenting a challenge in UTI management. Here, we developed a "diaper UTI test", which enables the quick detection of pyuria in ordinary diapers, and investigated its sensitivity and specificity in a clinical study. The diaper UTI test is based on a leukocyte esterase reaction. Reagent was prepared in liquid form so that it can be absorbed by disposable diapers, where it will produce a violet color in the presence of pyuria. For the clinical study, we enrolled children younger than 3 years with potential UTI who underwent bladder catheterization for urine culture and urinalysis. Of the 65 children included, 21 were diagnosed with UTI. The sensitivity and specificity of the diaper UTI test were 90.5% (95% CI 69.6-98.8) and 93.2% (95% CI 81.3-98.6), respectively. Because of its convenience and good sensitivity, the diaper UTI test may be useful in the screening of pediatric UTI.
尿路感染（UTI）是儿童中最常见的细菌感染之一。婴幼儿 UTI 的症状不具特异性，因此只要不能排除 UTI，就应检查尿液。然而，在临床环境中，收集未接受如厕训练的儿童的尿液有时较为困难，这给 UTI 的管理带来了挑战。在这里，我们开发了一种“尿布 UTI 检测”，可以快速检测普通尿布中的脓尿，并在临床研究中评估其敏感性和特异性。尿布 UTI 检测基于白细胞酯酶反应。试剂以液体形式制备，以便可被一次性尿布吸收，在存在脓尿的情况下，试剂会产生紫色。在临床研究中，我们纳入了因疑似 UTI 而接受膀胱导管插入术以进行尿液培养和尿液分析的 3 岁以下儿童。在 65 名纳入的儿童中，21 名被诊断为 UTI。尿布 UTI 检测的敏感性和特异性分别为 90.5%（95%CI 69.6-98.8）和 93.2%（95%CI 81.3-98.6）。由于其便利性和良好的敏感性，尿布 UTI 检测可能有助于儿童 UTI 的筛查。
