A clear urine specimen on visual inspection cannot totally exclude a diagnosis of urinary tract infection
QUESTION: Can visual inspection of urine specimen clarity be used to exclude a diagnosis of urinary tract infection (UTI)?
Design
Blinded comparison of visual inspection of urine specimen clarity with standard urinalysis (diagnostic standard).
Setting
The emergency department (ED) of a children's hospital in Cincinnati, Ohio, USA.
Participants
Convenience sample of 159 previously healthy patients <21 years of age (mean age 5.8 y, 77% girls) who had either a catheterised (44%) or midstream (56%) urine specimen collected for urine culture. Exclusion criteria were referral for evaluation of an abnormal urinalysis or positive urine culture, current antibiotic use, an underlying medical problem requiring repeat catheterisation (eg, neurogenic bladder), inability to obtain 3 ml of urine in excess of that required for the laboratory, or underlying renal or genitourinary abnormality.
Description of test and diagnostic standard
One investigator, blinded to patient clinical information, visually inspected the samples by holding a standard blood tube with 3 ml of …
