SHM Converge Scientific Abstract ePoster Gallery-Utility of Urinalysis and Procalcitonin in Detecting Urinary Tract Infections

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This retrospective study evaluated whether urinalysis (UA), alone or combined with procalcitonin (PCT), can accurately detect urinary tract infections (UTIs) in well-appearing febrile neonates aged 8–28 days. UTIs are a major cause of bacterial infection in this age group, and there is limited agreement on how reliable UA is in very young infants.<br /><br />Researchers reviewed 589 infant charts from a tertiary children’s hospital between 2018 and 2022. After exclusions, 385 infants met criteria, and 101 were diagnosed with UTI. Infants with prematurity, ICU admission, or significant comorbidities were excluded. A positive UTI was defined as at least 50,000 CFU/mL of a known urinary pathogen. UA was considered positive if leukocyte esterase (LE), nitrite, or pyuria (≥5 WBC/HPF) was present, and PCT was positive at ≥0.5 ng/mL.<br /><br />Escherichia coli was the most common pathogen, causing 95% of UTIs. Overall, UA performed well: aggregate UA had sensitivity of 0.96 and specificity of 0.87. LE alone had sensitivity of 0.98 and specificity of 0.92. Pyuria was slightly less accurate, while nitrite had very high specificity (0.99) but low sensitivity (0.32). The best performance came from combining UA with PCT, which achieved sensitivity of 1.0 and specificity of 0.97.<br /><br />The authors conclude that UA combined with PCT may improve diagnostic confidence for UTIs in febrile neonates 8–28 days old, potentially helping clinicians make decisions while awaiting culture results and possibly reducing unnecessary invasive testing, antibiotic use, and hospitalization costs. They recommend validating these findings in a larger cohort and assessing feasibility across pediatric centers.

Asset Subtitle

Jennifer T. Lemke

Meta Tag

Author List Ammar Kamil, Jennifer T. Lemke, Masheshwor Kafle

Category Research

Concept Urinary Tract Infection

Concept Febrile Neonate

Concept Infant Age 828 Days

Concept Urinalysis

Concept Procalcitonin

Distinguished Non-Finalist

Presenter Organization Phoenix Children's

Presenting Author Jennifer T. Lemke

Track Quality Improvement

Keywords

urinalysis

procalcitonin

febrile neonates

urinary tract infection

UTI diagnosis

leukocyte esterase

pyuria

nitrite

Escherichia coli

pediatric retrospective study

Urinary Tract Infection

Febrile Neonate

Infant Age 828 Days

Urinalysis

Procalcitonin