Læknablaðið - 15.02.1994, Page 26

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LÆKNABLAÐIÐ
oft sársaukafullar fyrir börn, auka hættu
á þvagfærasýkingu vegna ýmissa aðgerða
(blöðrumynd og blöðruspeglun) og valda
auk þess foreldrum fjárhagslegu tjóni vegna
fjarveru frá vinnu. Því ber læknum að vanda
vel til þvagsýnatöku hjá ungum börnum og
staðfesta þvagfærasýkingu, annað hvort með
ástungu- eða þvagleggsþvagi.
SUMMARY
Urinary tract infections in infants are common.
Unrecognized and untreated infections can have
serious consequences to the kidneys and can cause
serious diseases later in life. Urine specimens are
often obtained by adhesive bags in young children
and infants. The purpose of this study is to explore
the diagnostic value of urinary bag specimens in
diagnosing urinary tract infection in infants.
One hundred infants were studied prospectively at
the Pediatric Department of the University Hospital
in Iceland regardless of underlying diagnosis.
Urinary tract infection was confirmed in 7 children
by either a supra-pubic aspirate or a catheter
specimen. Thirty children had contaminated bag
specimens.
Mulitvariate regression analysis revealed that
microscopic bacterial and white blood cell count
correlated best with urinary tract infection (r: 0.42
and r2 change: 0.15 respectively, p< 0.05) but a
culture of the bag specimen correlated poorly ( r2
change: 0.03, p<0.05). Using bacterial count of
100.000 per ml. in a bag specimen as a cut off
value, had a positive predictive value of only 46%
but a negative predicive value of 99%.
It is concluded that a bag specimen cannot be
used reliably in diagnosing urinary tract infection
in infants. A properly collected urine by either a
supra-pubic aspirate or a catheter should be used
for diagnostic purposes.
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