Optimal bacterial colony counts for the diagnosis of upper urinary tract infections in infants
Background There are no consensus criteria for diagnosing upper urinary tract infections (UTI). Therefore, we conducted a study to assess whether bacterial colony counts of ≥ 10 3 CFU/ml are optimal for diagnosing upper UTIs among infants. Methods This retrospective observational study included 673...
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| Veröffentlicht in: | Clinical and experimental nephrology 2020-03, Vol.24 (3), p.253-258 |
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| creator | Akagawa, Yuko Kimata, Takahisa Akagawa, Shohei Fujishiro, Sadayuki Kato, Shogo Yamanouchi, Sohsaku Tsuji, Shoji Kino, Minoru Kaneko, Kazunari |
| description | Background
There are no consensus criteria for diagnosing upper urinary tract infections (UTI). Therefore, we conducted a study to assess whether bacterial colony counts of ≥ 10
3
CFU/ml are optimal for diagnosing upper UTIs among infants.
Methods
This retrospective observational study included 673 patients ( |
| doi_str_mv | 10.1007/s10157-019-01812-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2314009754</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2362192013</sourcerecordid><originalsourceid>FETCH-LOGICAL-c454t-a991801e47f6632686cd92328b9ee3f60eda92696d3993397e624ee1f1dc8fba3</originalsourceid><addsrcrecordid>eNp9kEFPHSEUhUlTU63tH-iiIenGzVQuMDB32Ri1JiZudFvCm7nYMfNghJnF-_fFPqtJFy7IPYTvnEsOY19AfAch7GkBAa1tBGA9Hcime8eOQCvbWIv4vmqlZQO2hUP2sZQHIUSHLX5ghwosSNTqiP26mZdx6ye-8f1CeayqT1OKuzrWuBQeUubLb-LD6O9jKmPhKfB1ninzNY_R5x1fcvXyMQbqlzHFUuXTzVf7J3YQ_FTo8_M8ZncX57dnP5vrm8ursx_XTa9bvTQeEToBpG0wRknTmX5AqWS3QSIVjKDBozRoBoWoFFoyUhNBgKHvwsarY3ayz51zelypLG47lp6myUdKa3FSgRYCbasr-u0_9CGtOdbfVcpIQClAVUruqT6nUjIFN-faU945EO6pfbdv39X23d_2XVdNX5-j182WhhfLv7oroPZAqU_xnvLr7jdi_wDG7o-4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2362192013</pqid></control><display><type>article</type><title>Optimal bacterial colony counts for the diagnosis of upper urinary tract infections in infants</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Akagawa, Yuko ; Kimata, Takahisa ; Akagawa, Shohei ; Fujishiro, Sadayuki ; Kato, Shogo ; Yamanouchi, Sohsaku ; Tsuji, Shoji ; Kino, Minoru ; Kaneko, Kazunari</creator><creatorcontrib>Akagawa, Yuko ; Kimata, Takahisa ; Akagawa, Shohei ; Fujishiro, Sadayuki ; Kato, Shogo ; Yamanouchi, Sohsaku ; Tsuji, Shoji ; Kino, Minoru ; Kaneko, Kazunari</creatorcontrib><description>Background
There are no consensus criteria for diagnosing upper urinary tract infections (UTI). Therefore, we conducted a study to assess whether bacterial colony counts of ≥ 10
3
CFU/ml are optimal for diagnosing upper UTIs among infants.
Methods
This retrospective observational study included 673 patients (<4 months of age) with urine samples obtained by catheterization for bacterial cultures. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were obtained when cutoff values of 10
3
, 10
4
, and 10
5
CFU/ml were used for diagnosing upper UTIs. Upper UTI patients were divided based on cutoff values: Group A (10
3
CFU/ml), Group B (10
4
CFU/ml), and Group C (≥ 10
5
CFU/ml).
Results
Of the 197 positive (≥ 10
3
CFU/ml) patients, 92 were diagnosed with an upper UTI. These patients were divided into Group A (
n
= 23), Group B (
n
= 16), and Group C (
n
= 53). No significant differences were detected in terms of clinical findings, including the incidence of vesicoureteral reflex. When cutoff values of 10
3
, 10
4
, and 10
5
CFU/ml were used for diagnosing upper UTIs, the sensitivity/specificity percentages were 100/81.3, 75.0/95.9, and 57.6/97.5, and the PPVs/NPVs were 46.7/100, 75.0/95.9, and 79.1/93.4.
Conclusion
Using ≥ 10
5
CFU/ml as a diagnostic threshold leads to approximately 40% of positive cases being missed. In contrast when ≥ 10
3
CFU/ml is used, all upper UTIs were identified. Therefore, bacterial colony counts of ≥ 10
3
CFU/ml should be considered the cutoff value for the diagnosis of upper UTIs in infants (< 4 months of age).</description><identifier>ISSN: 1342-1751</identifier><identifier>EISSN: 1437-7799</identifier><identifier>DOI: 10.1007/s10157-019-01812-8</identifier><identifier>PMID: 31712943</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Bacteria ; Catheterization ; Colonies ; Colony Count, Microbial ; Diagnosis ; Humans ; Infant ; Infants ; Medicine ; Medicine & Public Health ; Nephrology ; Original Article ; Predictive Value of Tests ; Retrospective Studies ; Urinary tract ; Urinary tract diseases ; Urinary tract infections ; Urinary Tract Infections - diagnosis ; Urinary Tract Infections - microbiology ; Urogenital system ; Urology</subject><ispartof>Clinical and experimental nephrology, 2020-03, Vol.24 (3), p.253-258</ispartof><rights>Japanese Society of Nephrology 2019</rights><rights>Clinical and Experimental Nephrology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c454t-a991801e47f6632686cd92328b9ee3f60eda92696d3993397e624ee1f1dc8fba3</citedby><cites>FETCH-LOGICAL-c454t-a991801e47f6632686cd92328b9ee3f60eda92696d3993397e624ee1f1dc8fba3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10157-019-01812-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10157-019-01812-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31712943$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Akagawa, Yuko</creatorcontrib><creatorcontrib>Kimata, Takahisa</creatorcontrib><creatorcontrib>Akagawa, Shohei</creatorcontrib><creatorcontrib>Fujishiro, Sadayuki</creatorcontrib><creatorcontrib>Kato, Shogo</creatorcontrib><creatorcontrib>Yamanouchi, Sohsaku</creatorcontrib><creatorcontrib>Tsuji, Shoji</creatorcontrib><creatorcontrib>Kino, Minoru</creatorcontrib><creatorcontrib>Kaneko, Kazunari</creatorcontrib><title>Optimal bacterial colony counts for the diagnosis of upper urinary tract infections in infants</title><title>Clinical and experimental nephrology</title><addtitle>Clin Exp Nephrol</addtitle><addtitle>Clin Exp Nephrol</addtitle><description>Background
There are no consensus criteria for diagnosing upper urinary tract infections (UTI). Therefore, we conducted a study to assess whether bacterial colony counts of ≥ 10
3
CFU/ml are optimal for diagnosing upper UTIs among infants.
Methods
This retrospective observational study included 673 patients (<4 months of age) with urine samples obtained by catheterization for bacterial cultures. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were obtained when cutoff values of 10
3
, 10
4
, and 10
5
CFU/ml were used for diagnosing upper UTIs. Upper UTI patients were divided based on cutoff values: Group A (10
3
CFU/ml), Group B (10
4
CFU/ml), and Group C (≥ 10
5
CFU/ml).
Results
Of the 197 positive (≥ 10
3
CFU/ml) patients, 92 were diagnosed with an upper UTI. These patients were divided into Group A (
n
= 23), Group B (
n
= 16), and Group C (
n
= 53). No significant differences were detected in terms of clinical findings, including the incidence of vesicoureteral reflex. When cutoff values of 10
3
, 10
4
, and 10
5
CFU/ml were used for diagnosing upper UTIs, the sensitivity/specificity percentages were 100/81.3, 75.0/95.9, and 57.6/97.5, and the PPVs/NPVs were 46.7/100, 75.0/95.9, and 79.1/93.4.
Conclusion
Using ≥ 10
5
CFU/ml as a diagnostic threshold leads to approximately 40% of positive cases being missed. In contrast when ≥ 10
3
CFU/ml is used, all upper UTIs were identified. Therefore, bacterial colony counts of ≥ 10
3
CFU/ml should be considered the cutoff value for the diagnosis of upper UTIs in infants (< 4 months of age).</description><subject>Bacteria</subject><subject>Catheterization</subject><subject>Colonies</subject><subject>Colony Count, Microbial</subject><subject>Diagnosis</subject><subject>Humans</subject><subject>Infant</subject><subject>Infants</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Urinary tract</subject><subject>Urinary tract diseases</subject><subject>Urinary tract infections</subject><subject>Urinary Tract Infections - diagnosis</subject><subject>Urinary Tract Infections - microbiology</subject><subject>Urogenital system</subject><subject>Urology</subject><issn>1342-1751</issn><issn>1437-7799</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kEFPHSEUhUlTU63tH-iiIenGzVQuMDB32Ri1JiZudFvCm7nYMfNghJnF-_fFPqtJFy7IPYTvnEsOY19AfAch7GkBAa1tBGA9Hcime8eOQCvbWIv4vmqlZQO2hUP2sZQHIUSHLX5ghwosSNTqiP26mZdx6ye-8f1CeayqT1OKuzrWuBQeUubLb-LD6O9jKmPhKfB1ninzNY_R5x1fcvXyMQbqlzHFUuXTzVf7J3YQ_FTo8_M8ZncX57dnP5vrm8ursx_XTa9bvTQeEToBpG0wRknTmX5AqWS3QSIVjKDBozRoBoWoFFoyUhNBgKHvwsarY3ayz51zelypLG47lp6myUdKa3FSgRYCbasr-u0_9CGtOdbfVcpIQClAVUruqT6nUjIFN-faU945EO6pfbdv39X23d_2XVdNX5-j182WhhfLv7oroPZAqU_xnvLr7jdi_wDG7o-4</recordid><startdate>20200301</startdate><enddate>20200301</enddate><creator>Akagawa, Yuko</creator><creator>Kimata, Takahisa</creator><creator>Akagawa, Shohei</creator><creator>Fujishiro, Sadayuki</creator><creator>Kato, Shogo</creator><creator>Yamanouchi, Sohsaku</creator><creator>Tsuji, Shoji</creator><creator>Kino, Minoru</creator><creator>Kaneko, Kazunari</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20200301</creationdate><title>Optimal bacterial colony counts for the diagnosis of upper urinary tract infections in infants</title><author>Akagawa, Yuko ; Kimata, Takahisa ; Akagawa, Shohei ; Fujishiro, Sadayuki ; Kato, Shogo ; Yamanouchi, Sohsaku ; Tsuji, Shoji ; Kino, Minoru ; Kaneko, Kazunari</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c454t-a991801e47f6632686cd92328b9ee3f60eda92696d3993397e624ee1f1dc8fba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Bacteria</topic><topic>Catheterization</topic><topic>Colonies</topic><topic>Colony Count, Microbial</topic><topic>Diagnosis</topic><topic>Humans</topic><topic>Infant</topic><topic>Infants</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Predictive Value of Tests</topic><topic>Retrospective Studies</topic><topic>Urinary tract</topic><topic>Urinary tract diseases</topic><topic>Urinary tract infections</topic><topic>Urinary Tract Infections - diagnosis</topic><topic>Urinary Tract Infections - microbiology</topic><topic>Urogenital system</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Akagawa, Yuko</creatorcontrib><creatorcontrib>Kimata, Takahisa</creatorcontrib><creatorcontrib>Akagawa, Shohei</creatorcontrib><creatorcontrib>Fujishiro, Sadayuki</creatorcontrib><creatorcontrib>Kato, Shogo</creatorcontrib><creatorcontrib>Yamanouchi, Sohsaku</creatorcontrib><creatorcontrib>Tsuji, Shoji</creatorcontrib><creatorcontrib>Kino, Minoru</creatorcontrib><creatorcontrib>Kaneko, Kazunari</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical and experimental nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Akagawa, Yuko</au><au>Kimata, Takahisa</au><au>Akagawa, Shohei</au><au>Fujishiro, Sadayuki</au><au>Kato, Shogo</au><au>Yamanouchi, Sohsaku</au><au>Tsuji, Shoji</au><au>Kino, Minoru</au><au>Kaneko, Kazunari</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Optimal bacterial colony counts for the diagnosis of upper urinary tract infections in infants</atitle><jtitle>Clinical and experimental nephrology</jtitle><stitle>Clin Exp Nephrol</stitle><addtitle>Clin Exp Nephrol</addtitle><date>2020-03-01</date><risdate>2020</risdate><volume>24</volume><issue>3</issue><spage>253</spage><epage>258</epage><pages>253-258</pages><issn>1342-1751</issn><eissn>1437-7799</eissn><abstract>Background
There are no consensus criteria for diagnosing upper urinary tract infections (UTI). Therefore, we conducted a study to assess whether bacterial colony counts of ≥ 10
3
CFU/ml are optimal for diagnosing upper UTIs among infants.
Methods
This retrospective observational study included 673 patients (<4 months of age) with urine samples obtained by catheterization for bacterial cultures. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were obtained when cutoff values of 10
3
, 10
4
, and 10
5
CFU/ml were used for diagnosing upper UTIs. Upper UTI patients were divided based on cutoff values: Group A (10
3
CFU/ml), Group B (10
4
CFU/ml), and Group C (≥ 10
5
CFU/ml).
Results
Of the 197 positive (≥ 10
3
CFU/ml) patients, 92 were diagnosed with an upper UTI. These patients were divided into Group A (
n
= 23), Group B (
n
= 16), and Group C (
n
= 53). No significant differences were detected in terms of clinical findings, including the incidence of vesicoureteral reflex. When cutoff values of 10
3
, 10
4
, and 10
5
CFU/ml were used for diagnosing upper UTIs, the sensitivity/specificity percentages were 100/81.3, 75.0/95.9, and 57.6/97.5, and the PPVs/NPVs were 46.7/100, 75.0/95.9, and 79.1/93.4.
Conclusion
Using ≥ 10
5
CFU/ml as a diagnostic threshold leads to approximately 40% of positive cases being missed. In contrast when ≥ 10
3
CFU/ml is used, all upper UTIs were identified. Therefore, bacterial colony counts of ≥ 10
3
CFU/ml should be considered the cutoff value for the diagnosis of upper UTIs in infants (< 4 months of age).</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>31712943</pmid><doi>10.1007/s10157-019-01812-8</doi><tpages>6</tpages></addata></record> |
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| ispartof | Clinical and experimental nephrology, 2020-03, Vol.24 (3), p.253-258 |
| issn | 1342-1751 1437-7799 |
| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Bacteria Catheterization Colonies Colony Count, Microbial Diagnosis Humans Infant Infants Medicine Medicine & Public Health Nephrology Original Article Predictive Value of Tests Retrospective Studies Urinary tract Urinary tract diseases Urinary tract infections Urinary Tract Infections - diagnosis Urinary Tract Infections - microbiology Urogenital system Urology |
| title | Optimal bacterial colony counts for the diagnosis of upper urinary tract infections in infants |
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