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Updates: Urinalysis for detection of urinary tract infection in febrile young infants

In a secondary analysis of a prospective observational study of over 4000 febrile infants 60 days of age or younger who were evaluated for urinary tract infection (UTI), a positive urinalysis (positive leukocyte esterase or nitrites on dipstick or >5 white blood cells [WBC]/high-power field on microscopy) had a sensitivity of 94 percent and a specificity of 91 percent. When UTI is defined as >50,000 colony-forming units on urine culture, this study found that urinalysis has high diagnostic accuracy in febrile young infants. Regardless of findings on urinalysis, a urine culture should be sent for all patients because a negative urine dipstick or urinalysis alone does not exclude a UTI.


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