Can We Improve Predictions of Urinary Tract Infections in Young Children?

The preliminary diagnosis of urinary tract infections (UTIs) in infants and young children, using urinalysis (UA) and microscopy results, typically relies on dichotomous cut-off values for UA components. Evidence of pyuria on UA (defined as any leukocyte esterase [LE] or ≥5 white blood cells [WBCs] per high-power microscopy field) often prompts treatment with empiric antibiotics. Researchers investigated whether calculating likelihood ratios for each interval value of UA components (e.g., negative, trace, 1+, 2+, 3+) versus using dichotomous cutoff values (e.g., negative versus positive) improved prediction of true UTIs.

Researchers analyzed 2144 UAs and the corresponding urine culture results from children (age, <2 years) seen in the emerge…