SciELO - Scientific Electronic Library Online

 
vol.91 número1Una experiencia en la evaluación de competencias en la lectura de electrocardiogramas por parte de posgrados de PediatríaEpisodio de hipotonía-hiporreactividad como evento supuestamente atribuido a la vacunación e inmunización. Reporte de un caso índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados

Revista

Articulo

Links relacionados

Compartir


Archivos de Pediatría del Uruguay

versión impresa ISSN 0004-0584versión On-line ISSN 1688-1249

Resumen

KUSTER, Natalia  y  ROBINO, Luciana. How to interpret suspicion tests and when to start empirical antibiotic therapy for urinary tract infections. Arch. Pediatr. Urug. [online]. 2020, vol.91, n.1, pp.21-28.  Epub 20-Feb-2020. ISSN 0004-0584.  https://doi.org/10.31134/ap.91.1.4.

Introduction:

urinary tract infections (UTIs) are a cause of frequent consultation. Nitrites and leukocyte esterase (LE) or leukocytes in urine are suspected markers, but their presence is variable.

Objective:

determine the validity of the suspicion tests and describe the antibiotic prescription based on the results.

Materials and methods:

descriptive, retrospective study of children with suspected UTIs analyzed with nitrites, EL and urine culture between 2016 and 2018.

Results:

137 patients were studied for suspected UTIs, and they were confirmed through urine cultures in 27 (19.7%). The main reason for suspected UTIs was fever of unknown origin (FUO) for children aged one month to 3 years of age, and leukocyte / LE sensitivity was 75%, specificity 65.6%, PPV 35.2% and NPV 91.3%. In the case of nitrites and LE the sensitivity was 43.7%, specificity 93.7%, PPV 63.6% and NPV 87%. For children of over 3 years of age, fever and urinary symptoms were the most frequent suspicion of UTI, but they showed low diagnostic sensitivity. Leukocyte sensitivity was 72.7%, specificity 72.9%, PPV 38.1% and NPV 92.1%. For leukocytes and nitrites, the sensitivity was 63.6%, specificity 93.7%, PPV 70% and NPV 91.8%. 65% of children of over 1 month of age with suspected UTI received empirical antibiotics. ITUs were confirmed in only 29.6% of those who received antibiotics.

Conclusions:

pediatric UTIs are over diagnosed. The symptoms’ low sensitivity and specificity as wekk as suspicion tests lead to an excessive use of antimicrobials.

Palabras clave : Urinary tract Infections; Anti-bacterial agents.

        · resumen en Español | Portugués     · texto en Español     · Español ( pdf )