Edwards A, van der Voort J, Newcombe R, Thayer H, Verrier Jones K
Department of General Practice, University of Wales College of Medicine, Llanedeyrn Health Centre, Cardiff, UK.
J Clin Pathol. 1997 Jul;50(7):569-72. doi: 10.1136/jcp.50.7.569.
Urinary tract infection in infancy continues to be underdiagnosed, despite its association with renal scarring and thus hypertension, renal failure, and other sequelae. Low ascertainment of urinary tract infections reflects the many difficulties in establishing a diagnosis, some of which could be eliminated by a simple, reliable method for preliminary investigation of children's urine.
To assess the accuracy of a new, simple method for testing urine for nitrite and leucocyte esterase, which could be applied to children in primary care.
An in vitro study was carried out to compare the results of conventional urine analysis with urine analysis on urine soaked on to panty-liners, and with the laboratory investigation. Two urine analysis stick types were used (Boehringer Mannheim Nephur sticks and Bayer Multistix 8SG) and two brands of panty-liners. Analysis examined evidence of agreement and bias for different methods in addition to sensitivity, specificity, and negative predictive values for urine analysis.
Pressing urine analysis test sticks on to panty-liners soaked with urine achieved consistent results compared with the results of conventional dipstick urine analysis. At a prevalence of 21.8%, sensitivity and negative predictive values of urine analysis for laboratory confirmed urinary tract infection were 94% and 98%, respectively, for Boehringer sticks, and 76% and 93%, respectively, for Bayer sticks. At prevalences of 5% and 1% (prevalences that could be expected in primary care) Bayer sticks had negative predictive values of 98.7% and 99.7%, respectively, and Boehringer sticks had values of 99.6% and 99.9%, respectively.
Testing urine on panty-liners is accurate compared with conventional urine analysis. It may be possible to apply this method to testing unwell children presenting in primary care to identify those who require microbiological urine culture to confirm or eliminate a diagnosis of urinary tract infection.
尽管婴儿期尿路感染与肾瘢痕形成相关，进而与高血压、肾衰竭及其他后遗症有关，但该疾病仍常被漏诊。尿路感染诊断率低反映出确诊存在诸多困难，其中一些困难可通过一种简单、可靠的儿童尿液初步检测方法得以消除。
评估一种新的、简单的尿液亚硝酸盐和白细胞酯酶检测方法的准确性，该方法可应用于基层医疗中的儿童。
开展一项体外研究，比较传统尿液分析结果与浸有尿液的卫生巾上尿液分析结果以及实验室检测结果。使用了两种尿液分析试纸类型（勃林格殷格翰Nephur试纸和拜耳Multistix 8SG试纸）以及两个品牌的卫生巾。分析除了检测尿液分析的敏感性、特异性和阴性预测值外，还考察了不同方法的一致性和偏差证据。
与传统试纸法尿液分析结果相比，将尿液分析试纸按压在浸有尿液的卫生巾上得到的结果一致。在患病率为21.8%时，对于实验室确诊的尿路感染，勃林格试纸的尿液分析敏感性和阴性预测值分别为94%和98%，拜耳试纸分别为76%和93%。在患病率为5%和1%（基层医疗中可能出现的患病率）时，拜耳试纸的阴性预测值分别为98.7%和99.7%，勃林格试纸分别为99.6%和99.9%。
与传统尿液分析相比，在卫生巾上检测尿液是准确的。将该方法应用于基层医疗中不适儿童的检测，以识别那些需要进行微生物尿液培养来确诊或排除尿路感染诊断的儿童，或许是可行的。
