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Whether the presence of bacteriuria on an automated urinalysis is diagnostic for urinary tract infection (UTI) in children has remained controversial.
A retrospective study of 2554 children aged <2 years (median, 6.1 months) seen in a children's hospital emergency room compared the results of automated urinalysis paired with urine cultures in diagnosing UTI; 19% of the sample had positive urine cultures.
The number of bacterial colonies on culture increased with the concentration of microscopic bacteriuria (graded as negative, trace, 1+ to 3+). With a bacterial count of 1+ or more, 60% had pyuria (5 or more white blood cells per high-power field). Among the urinalyses with isolated bacteriuria without pyuria (8%), only 10% had a positive cult…