Demonstration of C trachomatis in colposcopic cervical biopsy specimens

The results of a study of a screening test for urinary tract infection (UTI) in infants under 18 months is reported. Two hundred and forty three urine specimens were tested in the laboratory using AMES Multistix 8SG reagent strips read by photometer. The strips included three potential markers for urinary tract infection: leucocyte esterase, nitrite, and protein. The predictive value of a positive result (PPV) was low. The predictive value of negative test (NPV) when combining the screen of leucocyte esterase, nitrite, and protein was 99 4% with no difference between boys and girls. The test for leucocyte esterase had a 97-6% negative predictive value. An examination of the results by age confirms the good NPV in all age groups. Paediatricians should find Multistix 8SG strips a useful aid in the diagnosis of urinary tract infection in infants, and that costly culture of samples with negative strip tests can be avoided. Boreland and colleagues reported the diagnostic value of a screening test for urinary tract infection in paediatric inpatients using three tests: nitrite, blood, and protein.' We studied consecutive urine samples from 243 neonates and infants under 18 months: 85 were less than 28 days old; 81 aged between 21 and 182 days; and 77 were more than 182 days old. Our aim was to identify the dipstick test which gave the highest diagnostic accuracy in routine practice for this age group and to evaluate the leucocyte esterase test. Method Urine reagent strips for nitrite, leucocyte esterase, and protein were used (Multistick 8 SG AMES) and read by the Clinitek System photometer (AMES). All screening tests were performed by the same investigator in our laboratory. All samples were microscopically examined, cultured, and bacteria enumerated (DGU Institut Pasteur Production, France). The criteria for diagnosis of urinary tract infection2 were as follows: a combination of a white cell count of > 25 x 1O/l for boys or 50 x 1O9/l for girls under 8 days of age; > 10 x 109/1 for those older than 8 days; and a bacterial count of > 1O' ml-' with a maximum of two bacterial species. Samples with 104/ml-1 or less, or those with more than two bacterial species were considered contaminated. The statistical analysis of the screening tests results was based on Baye's tests and compared with the criteria for diagnosis of urinary tract infection.