Urinary tract infections (UTIs) represent a significant cause of serious bacterial infection in the pediatric population. Recently there has been much discussion surrounding the screening and diagnosis of UTIs. The American Academy of Pediatrics 2011 guidelines recommend suprapubic aspiration or catheterization in patients who cannot spontaneously void. Lavelle et al recently proposed a 2-step approach for the diagnosis of UTIs to reduce the number of catheterizations due to their invasiveness. The study suggests initially screening for leukocyte esterase and nitrates with a bagged sample before catheterization for culture.

However, a negative nitrite has little value in ruling out UTIs. Similarly, the sensitivity of leukocyte esterase has been cited as ∼79%, which is far from perfect for a screening test. In addition, a recent study by Shaikh et al found that children with UTIs caused by certain uropathogens other than Escherichia coli were less likely to...

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