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Bladder debris predicts positive urine culture in children

08 Feb 2018

In paediatric patients undergoing urological evaluation, the presence of bladder debris, regardless of severity, on ultrasound appears to predict a positive urine culture, a recent study has shown.

Researchers performed a retrospective review of 445 paediatric patients (mean age 5.8±4.1 years; 85 percent female), 20 percent of whom (n=87) tested positive for the urine culture. The overall rate of bladder debris was 22 percent (n=96).

Bladder debris was significantly more common in females, of whom 23 percent were positive. In comparison, only 12 percent of males had bladder debris (p=0.04).

Bladder debris was an acceptable predictive factor for positive urine culture, with a sensitivity and specificity of 52 and 86 percent, respectively. Almost half (47 percent) of those with bladder debris had positive urine cultures, significantly higher than the 12 percent of those without bladder debris (p<0.001).

The relative risk of a positive urine culture was significantly higher when bladder debris was present (3.90; 95 percent CI, 2.73–5.55). Despite a difference in the rate of bladder debris, males and females had statistically comparable rates of positive cultures. The presence of hydronephrosis (p=0.41) or vesicoureteral reflux (p=0.87) did not significantly alter the relationship between bladder debris and positive urine cultures.

In a subgroup analysis by degree, 40 participants were found to have severe bladder debris, 53 percent (n=21) of whom had positive urine cultures. In these patients, the sensitivity and specificity of bladder debris were 24 and 95 percent, respectively, while the relative risk of a positive urine culture was 3.22.

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