Table 3A.

Characteristics of Diagnostic Tests for UTI—Listed by Study, in Descending Order of Quality Score

AuthorTitleDateScoreQualityCommentsTestSensitivity, %Specificity, %
ConatantinosNitrite indicator strip test for bacteriuria19750.82GoodGold standard was culture by urine dipslideNitrite60.0100.0
Kunin and DeGroot94 Sensitivity of a nitrite indicator strip method in detecting bacteriuria in preschool girls19770.81FairGold standard was culture by urine dipslideNitrite82.0100.0
Hoberman et al12 Prevalence of urinary tract19930.81GoodHeavy bacteria16.070.0
 infection in febrile infants≥10 WBC/HPF32.064.0
≥5 WBC/HPF54.045.0
Any WBC/HPF77.047.0
Any bacteria86.011.0
Lowe95 Chemical screening and 19850.72FairGold standard was culture on CLED agarNitrite50.098.8
 prediction of bacteriuria—a Protein54.967.0
 new approachBlood strip63.660.4
Nitrite or protein73.167.0
Nitrite or blood80.460.5
Nitrite + blood + protein90.650.2
Corman et al96 Simplified urinary microscopy to 19820.72GoodWBC (>10/HPF)56.092.0
 detect significant bacteriuriaWBC (>5/HPF)64.091.0
Bacteriuria (>5/HPF)96.089.0
Bacteriuria (>10/HPF)88.093.0
Vickers et al97 Diagnosis of urinary tract infection in children: fresh urine microscopy or culture?19910.66FairBias, no clear gold standard, sensitivity calculated by the reviewer using culture as gold standard and uncertain microscopy results as negative; gold standard: culture of bag urine >10 million CFUMicroscopy96.0100.0
Lohr et al36 Making a presumptive diagnosis19930.63–0.36Fair to Prevalence biased; examines the test Dipstick, leukocyte79.472.7
 of urinary tract infection by good characteristics of various parallel andNitrite37.3100.0
 using a urinalysis performed in serial combinations of components of theMicroscopy, leukocytes80.484.3
 an on-site laboratory urine analysisLeukocytes or nitrite83.372.4
LE and nitrite or leukocytes88.271.7
Leukocytes or bacteria99.065.1
Bacteria99.071.0
LE, nitrite, or leukocytes100.057.6
Any test positive100.060.1
Bixler-Forell
Clinical evaluation of three rapid19850.63Good to Pediatric and adult patients; study of urine Lumac70.679.4
 et al42  methods for the detection of  fair cultures; no patient data; inpatients and Bac-T-screen64.266.9
 significant bacteriuria outpatients; no exclusion of antibiotic users; tables incomplete; gold standard culture with >10 000 CFUAMS74.383.5
AuthorTitleDateScoreQualityCommentsTestSensitivity, %Specificity, %
Aronson et al101 Combined suprapubic aspiration and clean-voided urine examination in infants and children19730.54GoodGold standard was culture of urine by suprapubic aspirationClean-voided urine 79.062.0
Shannon et al48 The diagnosis of bacteriuria by bladder puncture in infancy and childhood19690.54FairClean-catch urine 82.047.0
Aronson et al101 Combined suprapubic aspiration and clean-voided urine examination in infants and children19730.54GoodGold standard was culture of urine by suprapubic aspirationClean-voided urine 79.062.0
Shannon et al48 The diagnosis of bacteriuria by bladder puncture in infancy and childhood19690.54FairClean-catch urine 82.047.0
Pfaller et al31 The usefulness of screening tests for pyruia in combination with culture in the diagnosis of urinary tract infection19870.45GoodChamber count of WBCs
LE
 58.0
 67.0
97.0
92.0
Barbin et al50 Simplified microscopy for rapid detection of significant bacteriuria in random urine specimens19780.45Good to fairSimplified microscopy of urine specimen96.096.0
Lam et al38 Pyuria and bacteriuria19670.45FairGold standard was culture with >100 000 CFUWBC ≥ 10/1.6 mm3 100.093.0
Boreland and Dipstick analysis for screening of19860.36Good to Visually read nitrite55.297.9
 Stoker102  paediatric urine fairVisually read blood25.488.9
Visually read protein40.376.8
Photometrically read protein53.383.9
Photometrically read blood53.384.6
Photometrically read nitrite53.398.6
Visually read nitrite, blood, or protein80.697.9
Photometrically read nitrite, blood, or protein93.375.2
Cannon et al103 Rapid screening and19860.36GoodAmes nitrite61.099.0
 microbiologic processing of Bio-Dynamics nitrite72.099.0
 pediatric urine specimensBio-Dynamics 15-minute LE test84.077.0
Bio-Dynamics 1-minute LE test86.071.0
Bio-Dynamics nitrite with 1-minute LE test90.071.0
Bio-Dynamics nitrite with 15-minute LE test90.077.0
AuthorTitleDateScoreQualityCommentsTestSensitivity, %Specificity, %
Pylkkanen et al19 Diagnostic value of symptoms19790.33FairGold standard was culture by Leukocytes > 200/mL47.581.9
 and clean-voided urine suprapubic aspirationBacterial count, numerous45.692.9
 specimen in childhood urinary tract infectionUrine bag changed hourly until urine obtainedCulture of bag urine > 105 83.967.6
Houston39 Pus cell and bacterial counts in19630.27FairThe gold standard is the clinicalPyuria > 50/cmm89.098.0
 the diagnosis of urinary tract  diagnosis of urinary tract infectionCulture with >100 000 CFU88.098.0
 infections in childhoodOne or the other100.092.0
Goossens et al104 Prevalence of asymptomatic19850.18Fair to Gold standard was standard culture onNitrite15.090.0
 bacteriuria and comparison between different screening methods for its detection in children good CLED mediumDipslide100.0100.0
WiggelinkhuizenDipstick screening for urinary 19880.18FairA study comparing different brands of LE Multistix-993.463.9
 et al32  tract infection urine dipstick tests for urine analysisNitrite m-962.798.6
Nitrite c-962.798.9
Leukocytes and nitrite m-991.398.2
Leukocytes and nitrite c-993.198.6
LE Combur-994.169.2
Leukocytes or nitrite m-994.168.9
Leukocytes or nitrite c-995.468.7
Hoberman et al105 Cost-effective screening for urinary tract infection (UTI) in young children with fever1994NAGoodAbstract onlyPyuria > 10 WBC/mm3 89.696.0