This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bulloch, B.
Right arrow Articles by Dowd, M. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bulloch, B.
Right arrow Articles by Dowd, M. D.
Related Collections
Right arrow Genitourinary Tract

PEDIATRICS Vol. 106 No. 5 November 2000, p. e60

ELECTRONIC ARTICLE:
Can Urine Clarity Exclude the Diagnosis of Urinary Tract Infection?

Received Jan 20, 2000; accepted Jun 7, 2000.

Blake Bulloch*, Judith C. BausherDagger , Wendy J. PomerantzDagger , J. Michael Connors§, Melinda Mahabee-GittensDagger , and M. Denise Dowdparallel

From the * Children's Hospital, Winnipeg, Canada; Dagger  Children's Hospital Medical Center, Cincinnati, Ohio; § East Tennessee Children's Hospital, Knoxville, Tennessee; and parallel  Children's Mercy Hospital, Kansas City, Missouri.

Objectives.  To determine the association of clear urine by visual inspection with the absence of significant bacteruria, and to compare it with standard urinalysis.

Methods.  The study was performed in the emergency department of Children's Hospital Medical Center, Cincinnati, Ohio. It was a prospective, convenience sample of children <21 years of age who had catheterized or midstream clean-catch urine specimen collected for culture. Clinical findings including the presence or absence of fever, abdominal pain, dysuria, frequency, and urgency were collected for each patient. Urine was visually assessed for clarity by 2 independent observers using a standardized technique. Standard laboratory urinalysis and microscopy were also performed on all specimens. A positive urine culture was defined as >= 104 colony-forming unit (CFU)/mL of a urinary pathogen if obtained by catheterization and >= 105 CFU/mL if obtained by midstream.

Results.  Samples were obtained from 159 patients ranging in age from 4 weeks to 19 years. Females comprised 77% of the patients. One hundred ten of the samples (69%) were clear to visual inspection. There were a total of 29 positive cultures; however, 3 were in children with clear urine. The finding of clear urine on visual inspection had a negative predictive value of 97.3%. These results were similar to those obtained with standard urinalysis.

Conclusion.  Clear urine on visual inspection cannot completely eliminate the possibility that a child has a urinary tract infection. However, it is a reproducible test that offers the advantages of being simple, fast, and inexpensive. The finding of clear urine should be considered a reasonable and relatively effective bedside screen for the presence of a urinary tract infection.  Key words:  urinary tract infection, child, urine clarity, urinalysis, diagnosis.




This article has been cited by other articles:


Home page
 Evid. Based Nurs.Home page
G. E. Harkless
A clear urine specimen on visual inspection cannot totally exclude a diagnosis of urinary tract infection
Evid. Based Nurs., April 1, 2001; 4(2): 55 - 55.
[Full Text]