Systematic review of the validity of urine cultures collected by sterile perineal bags

array:24 ["pii" => "S2341287915002100" "issn" => "23412879" "doi" => "10.1016/j.anpede.2015.10.011" "estado" => "S300" "fechaPublicacion" => "2016-02-01" "aid" => "1862" "copyright" => "Asociación Española de Pediatría" "copyrightAnyo" => "2015" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2016;84:97-105" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2735 "formatos" => array:3 [ "EPUB" => 171 "HTML" => 1949 "PDF" => 615 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S1695403315001423" "issn" => "16954033" "doi" => "10.1016/j.anpedi.2015.04.003" "estado" => "S300" "fechaPublicacion" => "2016-02-01" "aid" => "1862" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2016;84:97-105" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5928 "formatos" => array:3 [ "EPUB" => 157 "HTML" => 4802 "PDF" => 969 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original" "titulo" => "Revisión sistemática de la validez de los urocultivos recogidos con bolsa estéril perineal" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "97" "paginaFinal" => "105" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Systematic review of the validity of urine cultures collected by sterile perineal bags" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figura 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1517 "Ancho" => 2642 "Tamanyo" => 265582 ] ] "descripcion" => array:1 [ "es" => "Sensibilidad y especificidad." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Ochoa Sangrador, A. Pascual Terrazas" "autores" => array:2 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Ochoa Sangrador" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Pascual Terrazas" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341287915002100" "doi" => "10.1016/j.anpede.2015.10.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287915002100?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315001423?idApp=UINPBA00005H" "url" => "/16954033/0000008400000002/v1_201601280025/S1695403315001423/v1_201601280025/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2341287915002082" "issn" => "23412879" "doi" => "10.1016/j.anpede.2015.10.009" "estado" => "S300" "fechaPublicacion" => "2016-02-01" "aid" => "1859" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2016;84:106-13" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2422 "formatos" => array:3 [ "EPUB" => 125 "HTML" => 1791 "PDF" => 506 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Validation of the Spanish version of the Parent's Postoperative Pain Management pain scale" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "106" "paginaFinal" => "113" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Validación de la versión española de la escala de evaluación del dolor postoperatorio Parent's Postoperative Pain Managament" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A.M. Ullan, M. Perelló, C. Jerez, E. Gómez, M.J. Planas, N. Serrallonga" "autores" => array:6 [ 0 => array:2 [ "nombre" => "A.M." "apellidos" => "Ullan" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Perelló" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Jerez" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Gómez" ] 4 => array:2 [ "nombre" => "M.J." "apellidos" => "Planas" ] 5 => array:2 [ "nombre" => "N." "apellidos" => "Serrallonga" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403315001241" "doi" => "10.1016/j.anpedi.2015.04.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315001241?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287915002082?idApp=UINPBA00005H" "url" => "/23412879/0000008400000002/v1_201601300058/S2341287915002082/v1_201601300058/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2341287915002136" "issn" => "23412879" "doi" => "10.1016/j.anpede.2015.10.014" "estado" => "S300" "fechaPublicacion" => "2016-02-01" "aid" => "1866" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2016;84:92-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2710 "formatos" => array:3 [ "EPUB" => 144 "HTML" => 1938 "PDF" => 628 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Combination of pulsed dye laser and propranolol in the treatment of ulcerated infantile haemangioma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "92" "paginaFinal" => "96" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Combinación de propranolol oral y láser de colorante pulsado en el tratamiento de los hemangiomas infantiles ulcerados" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 676 "Ancho" => 900 "Tamanyo" => 97264 ] ] "descripcion" => array:1 [ "en" => "Patient with ulcerated haemangioma in the nappy area." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Rodríguez-Ruiz, M.G. Tellado, J. del Pozo Losada" "autores" => array:3 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Rodríguez-Ruiz" ] 1 => array:2 [ "nombre" => "M.G." "apellidos" => "Tellado" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "del Pozo Losada" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403315001460" "doi" => "10.1016/j.anpedi.2015.04.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315001460?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287915002136?idApp=UINPBA00005H" "url" => "/23412879/0000008400000002/v1_201601300058/S2341287915002136/v1_201601300058/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Systematic review of the validity of urine cultures collected by sterile perineal bags" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "97" "paginaFinal" => "105" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "C. Ochoa Sangrador, A. Pascual Terrazas" "autores" => array:2 [ 0 => array:4 [ "nombre" => "C." "apellidos" => "Ochoa Sangrador" "email" => array:1 [ 0 => "cochoas2@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Pascual Terrazas" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Pediatría, Complejo Asistencial de Zamora y Escuela Universitaria de Enfermería de Zamora, Zamora, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Revisión sistemática de la validez de los urocultivos recogidos con bolsa estéril perineal" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 3143 "Ancho" => 2415 "Tamanyo" => 366803 ] ] "descripcion" => array:1 [ "en" => "Proportion of false positives. 95% CI: 95% confidence interval; Prev: proportion or prevalence." ] ] ] "textoCompleto" => "IntroductionUrinary tract infection (UTI) in paediatric patients is one of the most frequent causes of visits in the health care system, in Primary Care as well as in the emergency room, and it is a frequent cause of hospitalisation. In children, urinary tract infection symptoms are usually unspecific, such as fever without a source, food rejection or failure to thrive. That is why diagnostic confirmation with a urine culture is particularly important. Diagnostic methods must be quick and sensitive enough to facilitate prompt treatment and lower mortality rates, but specific enough to avoid unnecessary complementary tests and therapies.Currently, we have several techniques for the collection of urine samples from children. When the child has bladder control, the technique usually employed is the collection of urine from the urinary stream. In children who do not have bladder control, the most widely used method is the perineal adhesive bag, even though samples collected with this technique have a high risk of contamination or false positives. Samples collected through bladder catheterisation or suprapubic aspiration have a lower risk of contamination, but these are invasive, potentially risky techniques. Therefore, they are used as confirmatory tests or in emergency situations in which an immediate diagnosis or treatment is required.<a class="elsevierStyleCrossRefs" href="#bib0180">1,2</a> The use of sterile compresses, a technique employed in other countries, is uncommon in Spain.Several technical reports and clinical practice guidelines mention studies that show the limitations of the perineal bag for urine culture collection.<a class="elsevierStyleCrossRefs" href="#bib0180">1,3–5</a> However, no review studies have as yet quantified the principle problems associated with this sampling technique: the high risk of contamination and false positives. Our objective is to perform a systematic review to estimate the validity of samples collected with a perineal bag as a basis for clinical practice guidelines.Material and methodsBibliographic searchThe PUBMED, SCOPUS (including PUBMED and EMBASE) CINHAL, IBECS and CUIDEN databases were searched for articles published up to May 2014, with no restrictions on type of study, language, or year of publication.For PUBMED, SCOPUS and CINHAL, 2 search strategies were employed: 1 extensive search using the string (“infant”[MeSH Terms] OR “child”[MeSH Terms]) AND (“Urinary tract infections”[MeSh] OR (“Urine” AND “Culture”) OR (Urinary AND Infection)) AND (“Specimen Handling”[MeSh] OR Specim* OR “Urine Specimen Collection”[Mesh] OR “Bag” OR “Bags”) AND (“Urine/microbiology”[Mesh] OR “Contamination” OR “false positive” OR “Diagnosis”[Mesh] OR “Sensitivity and Specificity”[Mesh]”; and 1 simplified search using (“infant OR child”) AND “urine” AND “specimen handling”. In IBECS and CUIDEN, the equivalent terms in Spanish were employed. The references from the recovered studies were examined to identify other undetected studies.A total of 935 references were identified in the searches performed after the exclusion of duplicates. The titles and summaries of these references were reviewed and 40 full-text articles were selected. The references from the recovered articles were examined and 7 supplementary articles unidentified in the initial searches were found. The 47 recovered studies were examined to assess their inclusion in the review. The entire search and review process was performed in duplicate. Disagreements on criteria among the reviewers were resolved by consensus.Study selection criteriaThe studies selected were diagnostic test assessments, unlimited by design, language and date, that analysed urine samples for culture collected using a perineal bag from ambulatory or hospitalised paediatric patients of both genders with suspicion or at risk of UTI (excluding studies in healthy children). The studies had to include the number or percentage of contaminated samples (according to specified microbiological criteria) or false positives (positive urine culture with bag unconfirmed by urine cultures performed via suprapubic aspiration or bladder catheterisation). Studies with data that enabled the estimation of the sensitivity and specificity of urine cultures collected via perineal bag in comparison with urine cultures collected via bladder catheterisation or suprapubic aspiration were also included.Data extraction and quality assessmentFrom each study, information on sample size, country, area (hospital, emergency department or ambulatory patient), patient characteristics (age and sex), inclusion and exclusion criteria, assessed tests, assessment criteria, data (contaminated samples, true positives, false positives, false negatives and true positives), other results, quality and limitations were extracted in duplicate.The quality criteria assessed were:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">–Well-defined test or strategy: the information provided facilitates reproducibility.</li><li class="elsevierStyleListItem" id="lsti0010">–Valid assessment criterion: enables the culture to be classified correctly as contaminated, negative or positive.</li><li class="elsevierStyleListItem" id="lsti0015">–Representative sample: similar to the patient population found in clinical practice (no biased selection of positive samples or exclusion of contaminated samples).</li><li class="elsevierStyleListItem" id="lsti0020">–Independent comparison: the test assessment or interpretation and the assessment criterion are independent and objective.</li><li class="elsevierStyleListItem" id="lsti0025">–Diagnostic verification and incorporation bias control: the first one occurs when the reference test is performed with higher or lower likelihood according to the result of the diagnostic test to be assessed, and the second occurs when the diagnostic test result is part of the assessment criterion (e.g., positive urine cultures collected via bag are considered UTIs).</li><li class="elsevierStyleListItem" id="lsti0030">–Correct analysis: enough information is provided so that unbiased percentages of contaminated urines, false positives, sensitivity and specificity can be calculated.</li></ul>Statistical analysisA grouped analysis was performed for the percentages of contaminated and false positives, assuming random-effects models. The calculations and charts were generated with the MetaXL utility for Excel (EpiGear International Pty Ltd). For the calculation of grouped validity measures (sensitivity and specificity), the programme MetaDiSc (ES) v.1.1.1 was employed.<a class="elsevierStyleCrossRef" href="#bib0205">6</a> Heterogeneity indicators (Cochrane's Q & I2) and 95% confidence intervals (95% CI) were estimated for all the parameters. Tests for heterogeneity (Dersimonian and Laird) publication bias (Begg and Egger) and sensitivity (excluding individual studies) were performed. Analyses of subgroups, meta-regressions (geographical area and representative sample), Galbraith charts, cumulative and sensitivity charts were performed.ResultsOut of the 47 full-text articles examined, 21 that complied with the inclusion criteria were selected.<a class="elsevierStyleCrossRefs" href="#bib0210">7–27</a> The purpose of most of the studies included was to determine the validity of the perineal bag versus other techniques through different estimators. In 15 studies.<a class="elsevierStyleCrossRefs" href="#bib0210">7,12–14,16–18,21,22,24–27</a> contaminated samples were estimated, and in 12<a class="elsevierStyleCrossRefs" href="#bib0220">9,15–17,19,20,23,25</a> false positives were estimated. The validity related to an external reference pattern was determined in only 5 studies.<a class="elsevierStyleCrossRefs" href="#bib0220">9,11,13,16,17</a> One article was excluded because it analysed urine samples by a test strip and not by culture.<a class="elsevierStyleCrossRef" href="#bib0315">28</a><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the simplified characteristics of the 21 studies included in the meta-analysis. The studies were carried out in different countries, but their assessment methods and characteristics were very similar. They included a total of 14,759 patients, 7659 with urine bag samples. The ages of the children included in the study are similar, between 1 day and 3 years of age, except for some studies that included some older patients.<a class="elsevierStyleCrossRefs" href="#bib0230">11,14</a> The children included had clinical symptoms (most of them with fever without source), suspicion of UTI, or prior positive cultures using a non-sterile urine collection technique. Gender-specific variables are specified in 5 studies,<a class="elsevierStyleCrossRefs" href="#bib0215">8,11,12,17,23</a> with a discrete higher frequency of girls.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the quality assessment of all the studies included in the meta-analysis. The assessment criteria employed for sample contamination or sample positivity/negativity is appropriate, although only one third of the studies use a complete reference pattern for all the samples. In half of the studies, the sample presents some type of bias, mainly in those that assessed sensitivity and specificity, since the analyses do not include contaminated samples. In other studies, the sample includes an over-representation of patients with previously positive urines. None of the studies detail procedures that guarantee the independent or blind assessment of the compared tests, although culture interpretation is a relatively objective test. The biased incorporation of bag samples with positive culture is common in several studies. Finally, all the studies included offer data that enable a correct analysis, although a complete validity assessment can be performed in only one quarter of studies.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia><a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a> show the meta-analysis of contaminated samples and false positives with perineal bag. <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the pooled measurements for perineal bag and those of other samples analysed in the studies reviewed. For urine collected with the bag, the weighted percentage of contaminated urines is 46.6%, and for false positives 61.1%. In the meta-regression analyses, we found that studies with representative patient samples had a significantly lower percentage of false positives; therefore, we performed a meta-analysis by subgroups. All the analyses show important heterogeneity (I2>50%), although we were unable to identify a particular study that, when excluded, would reduce heterogeneity. The publication bias tests (Begg and Egger) showed no statistical significance.<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia>In two studies<a class="elsevierStyleCrossRefs" href="#bib0215">8,17</a> the data from boys and girls was estimated separately, showing a higher risk of contaminated urine in boys (38.9% vs 29.2%; odds ratio [OR] 1.53; 95% CI: 1.36–1.72). The same was done for false positives in 4 studies, and no significant differences were found (OR: 0.96; 95% CI: 0.25–3.65). For samples collected via urinary stream and bladder catheterisation, the risks of contaminated urine or false positives are clearly lower.<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a> shows the meta-analysis for validity indicators of culture with perineal bag in comparison with the sterile technique. The weighted specificity and sensitivity are 82% and 88%, respectively. These estimates do not present heterogeneity.<elsevierMultimedia ident="fig0015"></elsevierMultimedia>DiscussionAlthough the use of urine collection for culture via perineal bag is widespread, the available evidence indicates that it is not a very valid method due to the high risk of contaminated samples and false positives. The studies retrieved from the bibliographic search, however, are extremely heterogeneous; therefore, these findings could be inexact. Although the heterogeneity observed could be unacceptable for relative risk measurements, it is common to find rates of over 90% in meta-analyses of prevalence studies.<a class="elsevierStyleCrossRefs" href="#bib0320">29–35</a> In fact, in risk meta-analyses, the baseline prevalence differences between studies, which are partially compensated by the relative measurements, are one of the main heterogeneity determinants.Even the most optimistic estimates show that this urine collection technique is unreliable. The fact that 1 out of every 2 urine cultures collected with a perineal bag is contaminated or gives a false positive compromises the usefulness of the technique, or should at least make us question the validity of its results.The high percentages of contamination and false positives are related to the collection procedure, i.e., cleanliness, placement and replacement of the perineal bag. The risk of contamination varies depending on the meticulousness of the procedure followed.<a class="elsevierStyleCrossRef" href="#bib0225">10</a> Based on our results, the risk of urine contamination in children is somewhat higher, although it is unacceptably high in both cases. Although the percentage of false positives is lower in the studies in which the samples do not include an over-representation of patients with prior positive urine cultures, it is, in any case, very high. These studies were not excluded from the meta-analysis because it is common for new samples for culture to be collected from children with prior positive urine cultures (with bag). This tends to overestimate the positive cases in the samples, but it should not affect the confirmation percentage (false positives) of reference techniques.It is surprising to observe that the 5 studies assessing the validity of sterile collection techniques found them to have a sensitivity and specificity of over 80%. It is evident that the exclusion of contaminated samples (which are neither positive nor negative, and are common in clinical practice) from the validity analysis would bias the estimation. Nevertheless, we cannot rule out the existence of certain settings and patient populations in which these results would be valid if strict hygiene measures are enforced.The results of this review show the limitations of the studies included. Most of them are of medium quality, since none include such an important criterion as the blind or independent assessment of the diagnostic test and the reference criterion. In addition, the patient samples included are not sufficiently representative due to bias in the inclusion of samples previously positive or contaminated. Likewise, it is surprising that most of the studies are carried out in the hospital environment, although many of the children with UTI symptoms are seen at primary care clinics.Although different documents and clinical practice guidelines already recommend the use of other urine collection techniques when a reliable diagnosis is essential,<a class="elsevierStyleCrossRefs" href="#bib0180">1,2</a> the findings of this review quantify the importance and significance of this recommendation. Considering the high risk of contamination, the perineal bag cannot be used to collect a sample for culture in a high-risk patient requiring immediate antibiotic treatment. A finding of contaminated urine will not confirm or rule out infection, and a positive finding runs a high risk of being false. Also, the antibiotic administered would interfere with the validity of the new urine sample that would have to be collected to confirm diagnosis. The diagnostic uncertainty would affect not only treatment but also the decision to perform further diagnostic tests or follow-up studies. The iatrogenic cascade triggered by each wrong diagnosis must also be considered.In low-risk patients, in whom diagnosis is unlikely and treatment delay acceptable, we could collect the urine with a bag and wait for the result. The less invasive character and ease of this technique have made it the gold standard in our clinical practice. However, it is important to bear in mind that only negative results will be acceptable because the positive ones will most likely be false and will have to be confirmed with more valid urine collection techniques (bladder catheterisation or suprapubic aspiration). This recommendation, included in consensus documents,<a class="elsevierStyleCrossRefs" href="#bib0180">1,2</a> is pragmatic, even assuming that meticulous cleaning, placement and replacement of the bag will minimise the drawbacks of this urine collection technique.We conclude that the perineal adhesive bag is not a sufficiently valid method for collecting urine for culture, since almost half of the cultures will be contaminated and 2 out of 3 positives will be false. Even though the estimates are inaccurate, due to the heterogeneity of the studies available, they must be considered when choosing the urine collection method. The sensitivity and specificity estimates are not applicable since they do not take into account the risk of contamination.Conflict of interestThe authors declare that there are no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres600569" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec614813" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres600570" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec614814" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Material and methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Bibliographic search" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Study selection criteria" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Data extraction and quality assessment" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0040" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflict of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-02-24" "fechaAceptado" => "2015-04-08" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec614813" "palabras" => array:5 [ 0 => "Urinary tract infections" 1 => "Urine/microbiology" 2 => "Urine specimen collection" 3 => "Sensitivity and specificity" 4 => "Meta-analysis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec614814" "palabras" => array:5 [ 0 => "Infección urinaria" 1 => "Orina/microbiología" 2 => "Recogida de muestra de orina" 3 => "Sensibilidad y especificidad" 4 => "Metaanálisis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionThe perineal adhesive bag is the most commonly used method in our country for urine culture collection in infants, despite having a high risk of contamination and false-positive results. We aim to quantify both types of risks through a systematic review. MethodsSearch updated in May 2014 in PUBMED, SCOPUS (includes EMBASE), IBECS; CINAHL, LILACS AND CUIDEN, unrestricted by language or date. Percentage of contaminated samples, false positives, sensitivity and specificity (with respect to catheterization or bladder puncture) were recorded. ResultsA total of 21 studies of medium quality (7659 samples) were selected. The pooled percentage of contaminated samples was 46.6% (15 studies; 6856 samples; 95% confidence interval [95% CI]: 35.6–57.8%; I2: 97.3%). The pooled percentage of false positives was 61.1% (12 studies; 575 samples; 95% CI: 37.9–82.2%; I2: 96.2%). Sensitivity (88%; 95% CI: 81–93%; I2: 55.2%) and specificity (82%; 95% CI: 75–89%; I2: 41.3%) were estimated in five studies, but without including contaminated samples. ConclusionThe perineal adhesive bag is not a valid enough method for urine culture collection, because almost half of all samples are contaminated, and two out of three positives are false. Although these estimates are imprecise, because of their great heterogeneity, they should be considered when choosing the method of urine collection. The estimates of sensitivity and specificity are not applicable because they do not take into account the risk of contamination." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónLa bolsa adhesiva perineal es el método más usado en nuestro medio para la recogida de orina para cultivo en el lactante, a pesar de que presenta un alto riesgo de contaminación y de resultados falsos positivos. Nos proponemos cuantificar ambos riesgos a través de una revisión sistemática. MétodosBúsqueda actualizada a mayo del 2014 en PUBMED, SCOPUS (incluye EMBASE), IBECS; CINHAL, LILACS Y CUIDEN, sin límites de idioma ni tiempo. Se extrajeron porcentajes de orinas contaminadas, falsos positivos, sensibilidad y especificidad (respecto cateterismo o punción vesical). ResultadosSe seleccionaron 21 artículos de calidad media (7.659 muestras). El porcentaje agrupado de orinas contaminadas fue del 46,6% (15 estudios; 6.856 muestras; intervalo de confianza del 95% [IC del 95%], 35,6 a 57,8%; I2: 97,3%). El porcentaje agrupado de falsos positivos fue del 61,1% (12 estudios; 575 muestras; IC del 95%, 37,9 a 82,2%; I2: 96,2%). En 5 estudios se pudieron estimar la sensibilidad (88%; IC del 95%, 81 a 93%; I2: 55,2%) y especificidad (82%; IC del 95%, 75 a 89%; I2: 41,3%), aunque en los recuentos no se incluyeron orinas contaminadas. ConclusiónLa bolsa adhesiva perineal no es un método suficientemente válido para cultivo de orina porque casi la mitad resultarán contaminados y de los positivos 2 de cada 3 serán falsos. Aun siendo estimaciones imprecisas, por su gran heterogeneidad, deben ser tenidas en cuenta en la elección del método de recogida de orina. Las estimaciones de sensibilidad y especificidad no son aplicables por no considerar el riesgo de contaminación." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Ochoa Sangrador C, Pascual Terrazas A. Revisión sistemática de la validez de los urocultivos recogidos con bolsa estéril perineal. An Pediatr (Barc). 2016;84:97–105." ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2236 "Ancho" => 2263 "Tamanyo" => 287977 ] ] "descripcion" => array:1 [ "en" => "Proportion of contaminated samples. 95% CI: 95% confidence interval; Prev: proportion or prevalence." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 3143 "Ancho" => 2415 "Tamanyo" => 366803 ] ] "descripcion" => array:1 [ "en" => "Proportion of false positives. 95% CI: 95% confidence interval; Prev: proportion or prevalence." ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1555 "Ancho" => 2616 "Tamanyo" => 265655 ] ] "descripcion" => array:1 [ "en" => "Sensitivity and specificity." ] ] 3 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "Catheter: bladder catheterisation; stream: urinary stream; compress: sterile compress; NA: not applicable; NS: not stated; aspiration: suprapubic aspiration." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Study. Country; scope \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Number (bag); age<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sample assessed (+)<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Contamination criterion<a class="elsevierStyleCrossRef" href="#tblfn0015">c</a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Reference criterion (+)<a class="elsevierStyleCrossRef" href="#tblfn0020">d</a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Positive<a class="elsevierStyleCrossRef" href="#tblfn0025">e</a> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Al Orifi 2000. Canada; Emergency department \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7584 (5127); ≤24 months (NS) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag (≥104) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed or 1 organism (103–104) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Alam 2005. Brazil; hospital (admission) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">191 (169); <3 years (admitted) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag, compress or stream (≥105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed or <105 only 2 methods \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Benito 1996. Spain; Emergency department \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">61 (61); <1 year (culture [+] or clinical symptoms) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag (≥105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Undefined \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Aspiration (>0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">27.1% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Biassini 1974. Italy; hospital \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">404 (152); newborn (suspicion of bacteriuria) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag in supine or prone, stream (≥104) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><103 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">If confirmed in 3 samples (bag or stream) aspiration \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.9% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Braude 1967. United Kingdom; NS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">68 (16); 9 days to 11 years (UTI clinical symptoms) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag, stream (≥104) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Undefined \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Catheter (≥104) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">33.8% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Conn 1970. United Kingdom; hospital (admission) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">152 (56); <3 years (suspicion of UTI) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag, stream (≥104) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Aspiration (≥104) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Etoubleau 2009. France; Emergency department \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">192 (192); <3 years (fever) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag (≥105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Catheter (≥103) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">53.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Feasey 1999. United Kingdom; hospital \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50 (50); 1 day to 5 years (UTI clinical symptoms) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag, compress (≥105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed to one (<105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Gilljam 2008. Sweden; Emergency department \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">61 (61); <2 years (prior [+] culture) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag (≥105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Undefined \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Catheter (≥105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">52.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Grisaru-Soen 2000. Israel; hospital \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50 (50); <18 months (UTI or sepsis clinical symptoms) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag (NS) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Aspiration (NS) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hardy 1976. United Kingdom; hospital (admission) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30 (30); 1 day to 3 years (ITU clinical symptoms and prior culture [+]) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag, stream (≥105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Aspiration (>105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Karacan 2010. Turkey; hospital \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.067 (517); <16 months (UTI clinical symptoms) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag, stream (≥105,) catheter (>104) or aspiration (>0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Undefined \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13.6% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Leong 1976. Singapore; hospital \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">174 (174); <2 years (2 prior [+] cultures) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag, stream (≥105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Aspiration (≥105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Li 2002. China; hospital (office visit) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">100 (100); 1–24 months (prior UTI with prophylaxis) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag (≥105) with nitrites and leukocytes or 2 culture [+] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Second urine culture (−) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Aspiration (Gram + ≥1000 Gram −) catheter (>0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">MacDonald 1985. Canada; Hospital (admission) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">262 (204); 1–24m (routine at admission) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag, stream (>105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed or <105 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Macfarlane 1999. United Kingdom; hospital \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">362 (34); <2 years (fever) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag, compress, stream (NS) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.1% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Martín Puerto 1999. Spain; Emergency department \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">42 (42); <27 months (2 cultures [+]) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag (≥105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Undefined \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Catheter (≥20,000) or aspiration (>0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">McCune 1989. United Kingdom; hospital (admission) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">46 (23); NS (admitted) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag, stream \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Méndez 2003. Chile; hospital \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">198 (198); <24 months (culture ≥104 at 24h) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag (≥105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Aspiration (>0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Schroeder 2005. U S; Emergency department \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3066 (390); <3 months (fever) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag (≥105,) catheter (≥104) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed or <104 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10.8% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Tosif 2012. Australia; hospital \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">599 (13); <2 years (UTI clinical symptoms) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bag, stream (≥105,) aspiration or catheter (>10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mixed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab982575.png" ] ] ] "notaPie" => array:5 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Sample: number of samples (number of samples with bag), age (selection criterion)." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "Test assessed: type of samples for culture (positive criterion: growth count for one micro-organism in ufc/ml)." ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "c" "nota" => "Contamination criterion: mixed (growth of more than one micro-organism)." ] 3 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "d" "nota" => "Reference criterion: type of sample and positive criterion (cut-off point in cfu/ml)." ] 4 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "e" "nota" => "Positive: percentage of positives with the reference criterion or in its absence with positive criterion of the assessed sample." ] ] ] "descripcion" => array:1 [ "en" => "Characteristics of the studies included in the meta-analysis." ] ] 4 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "A: well-defined test or strategy; B: valid assessment criterion; C: representative sample; D: independent comparison; E: diagnostic verification and incorporation bias control; F: correct analysis." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Study \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">A \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">B \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">C \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">D \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">E \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">F \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Al Orifi, 2000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Alam, 2005 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Benito, 1996 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Biassini, 1974 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Braude, 1967 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Conn, 1970 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Etoubleau, 2009 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Feasey, 1999 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Gilljam, 2008 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Grisaru-Soen, 2000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hardy, 1976 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Karacan, 2010 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Leong, 1976 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Li, 2002 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">MacDonald, 1985 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Macfarlane, 1999 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Martín Puerto, 1999 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">McCune, 1989 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Méndez, 2003 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Schroeder, 2005 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Tosif, 2012 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab982573.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Quality of the studies included in the meta-analysis." ] ] 5 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sample measure \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Studies (patients) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Heterogeneity I2 (p) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Median (IQR) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Contaminated urine</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Perineal bag \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (6856) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46.6% (35.6 to 57.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">97.3% (p<0.001) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46% (30 to 65%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Urinary stream \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (1305) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.5% (13.1 to 31.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80.1% (p<0.001) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15% (14 to 29%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Bladder catheterisation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (3853) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.23% (5.5 to 11.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80.8% (p<0.001) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9% (7 to 13%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">False positives</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Perineal bag \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (575) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">61.1% (37.9 to 82.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">96.2% (p<0.001) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65% (46 to 83%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Representative sample</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (177) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.2% (8.9 to 61.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">90% (p<0.001) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42% (14 to 69%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (398) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">73.6% (56.6 to 87%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">90% (p<0.001) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">71% (53 to 86%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Urinary stream \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (282) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22.8% (8.3 to 41.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">70% (p=0.018) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24% (14 to 49%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab982574.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Grouped meta-analysis results for contamination and false positives. Weighed percentages with their 95% confidence interval (95% CI), heterogeneity (I2), Dersimonian and Laird contrast (p), medians and interquartile ranges (IQR)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib0180" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Grupo de trabajo de la Guía de Práctica Clínica sobre Infección del Tracto Urinario en la Población Pediátrica. Guía de Práctica Clínica sobre Infección del Tracto Urinario en la Población Pediátrica. Plan de Calidad para el Sistema Nacional de Salud del Ministerio de Sanidad, Política Social e Igualdad. Instituto Aragonés de Ciencias de la Salud; 2011. Guías de Práctica Clínica en el SNS: I+CS No 2009/01." ] ] ] 1 => array:3 [ "identificador" => "bib0185" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Métodos para la recogida de muestras de orina para urocultivo y perfil urinario" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Grupo Investigador del Proyecto" "etal" => false "autores" => array:2 [ 0 => "C. Ochoa Sangrador" 1 => "M.F. Brezmes Valdivieso" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2007" "volumen" => "67" "paginaInicial" => "442" "paginaFinal" => "449" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0190" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Urinary tract infection: Diagnosis, treatment and long-term management of urinary tract infection in children. National Collaborating Centre for Women's and Children's Health. RCOG Press. August 2007. Surveillance Review October 2013. Available at: <a id="intr0010" class="elsevierStyleInterRef" href="http://www.nice.org.uk/nicemedia/pdf/CG54fullguideline.pdf">http://www.nice.org.uk/nicemedia/pdf/CG54fullguideline.pdf</a> [accessed 11.12.14]." ] ] ] 3 => array:3 [ "identificador" => "bib0195" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Technical report—diagnosis and management of an initial UTI in febrile infants and young children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.M. Finnell" 1 => "A.E. Carroll" 2 => "S.M. Downs" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2011-1332" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2011" "volumen" => "128" "paginaInicial" => "e749" "paginaFinal" => "e770" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21873694" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0200" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical effectiveness and cost-effectiveness of tests for the diagnosis and investigation of urinary tract infection in children: a systematic review and economic model" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Whiting" 1 => "M. Westwood" 2 => "L. Bojke" 3 => "S. Palmer" 4 => "G. Richardson" 5 => "J. Cooper" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Health Technol Assess" "fecha" => "2006" "volumen" => "10" "paginaInicial" => "1" "paginaFinal" => "172" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17134596" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0205" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meta-DiSc: a software for meta-analysis of test accuracy data" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Zamora" 1 => "V. Abraira" 2 => "A. Muriel" 3 => "K. Khan" 4 => "A. Coomarasamy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1471-2288-6-31" "Revista" => array:5 [ "tituloSerie" => "BMC Med Res Methodol" "fecha" => "2006" "volumen" => "6" "paginaInicial" => "31" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16836745" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0210" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of urine contamination rates using three different methods of collection: clean-catch, cotton wool pad and urine bag" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.T. Alam" 1 => "J.B. Coulter" 2 => "J. Pacheco" 3 => "J.B. Correia" 4 => "M.G. Ribeiro" 5 => "M.F. Coelho" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1179/146532805X23326" "Revista" => array:6 [ "tituloSerie" => "Ann Trop Paediatr" "fecha" => "2005" "volumen" => "25" "paginaInicial" => "29" "paginaFinal" => "34" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15814046" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0215" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Urine culture from bag specimens in young children: are the risks too high?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F. Al-Orifi" 1 => "D. McGillivray" 2 => "S. Tange" 3 => "M.S. Kramer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1067/mpd.2000.107466" "Revista" => array:6 [ "tituloSerie" => "J Pediatr" "fecha" => "2000" "volumen" => "137" "paginaInicial" => "221" "paginaFinal" => "226" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10931415" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0220" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infección urinaria en el lactante: comprobación por punción suprapúbica del rendimiento del cultivo de orina obtenido por bolsa perineal" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Benito Fernández" 1 => "J. Sanchez Echeniz" 2 => "S. Mintegui Raso" 3 => "M. Montejo Fernandez" 4 => "A. Calabia De Diego" 5 => "J.A. Portillo Martin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "An Esp Pediatr" "fecha" => "1996" "volumen" => "45" "paginaInicial" => "149" "paginaFinal" => "152" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8967643" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0225" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Screening for bacteriuria in newborns: experience with plastic bags" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G.G. Biasini" 1 => "C. Vullo" 2 => "M. Petrone" 3 => "E. Pistocchi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Helv Paediatr Acta" "fecha" => "1974" "volumen" => "29" "paginaInicial" => "575" "paginaFinal" => "581" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4457515" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0230" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis of urinary tract infection in childhood based on examination of pared non-catheter and catheter specimens of urine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H. Braude" 1 => "J.O. Forfar" 2 => "J.C. Gould" 3 => "J.W. McLeod" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br Med J" "fecha" => "1967" "volumen" => "4" "paginaInicial" => "702" "paginaFinal" => "705" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4591001" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0235" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A study of some of the methods of urinary collection in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "N.K. Conn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Pathol" "fecha" => "1970" "volumen" => "23" "paginaInicial" => "81" "paginaFinal" => "84" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5439094" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0240" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Moving from bag to catheter for urine collection in non-toilet-trained children suspected of having urinary tract infection: a paired comparison of urine cultures" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Etoubleau" 1 => "M. Reveret" 2 => "D. Brouet" 3 => "I. Badier" 4 => "P. Brosset" 5 => "L. Fourcade" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpeds.2009.01.008" "Revista" => array:6 [ "tituloSerie" => "J Pediatr" "fecha" => "2009" "volumen" => "154" "paginaInicial" => "803" "paginaFinal" => "806" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19375715" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0245" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Are Newcastle urine collection pads suitable as a means of collecting specimens from infants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Feasey" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Paediatr Nurs" "fecha" => "1999" "volumen" => "11" "paginaInicial" => "17" "paginaFinal" => "21" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10723377" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0250" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "In-out catheterization of young children with suspected urinary tract infection: a retrospective journal study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B.M. Gilljam" 1 => "M.L. Svensson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Paediatr Nurs" "fecha" => "2008" "volumen" => "34" "paginaInicial" => "241" "paginaFinal" => "245" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0255" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "False-positive urine cultures using bag collection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G. Grisaru-Soen" 1 => "R. Goldman" 2 => "A. Barzilai" 3 => "D. Lotan" 4 => "N. Keller" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Pediatr (Phila)" "fecha" => "2000" "volumen" => "39" "paginaInicial" => "499" "paginaFinal" => "500" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0260" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of sterile bag, clean catch and suprapubic aspiration in the diagnosis of urinary infection in early childhood" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.D. Hardy" 1 => "P.M. Furnell" 2 => "W. Brumfitt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Urol" "fecha" => "1976" "volumen" => "48" "paginaInicial" => "279" "paginaFinal" => "283" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/963408" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0265" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of urine collection methods for the diagnosis of urinary tract infection in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Karacan" 1 => "N. Erkek" 2 => "S. Senel" 3 => "S. Akin Gunduz" 4 => "G. Catli" 5 => "B. Tavil" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000273068" "Revista" => array:6 [ "tituloSerie" => "Med Princ Pract" "fecha" => "2010" "volumen" => "19" "paginaInicial" => "188" "paginaFinal" => "191" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20357500" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0270" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bladder aspiration for diagnosis of urinary tract infection in infants and young children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Y.Y. Leong" 1 => "K.W. Tan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Singap Paediatr Soc" "fecha" => "1976" "volumen" => "18" "paginaInicial" => "43" "paginaFinal" => "47" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0275" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is bag urine culture useful in monitoring urinary tract infection in infants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P.S. Li" 1 => "L.C. Ma" 2 => "S.N. Wong" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Paediatr Child Health" "fecha" => "2002" "volumen" => "38" "paginaInicial" => "377" "paginaFinal" => "381" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12174000" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0280" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy of chlorhexidine cleansing in reducing contamination of bagged urine specimens" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "N.E. MacDonald" 1 => "S. Collison" 2 => "N. Wolfish" 3 => "P.N. McLaine" 4 => "A.M. Mackenzie" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "CMAJ" "fecha" => "1985" "volumen" => "133" "paginaInicial" => "1211" "paginaFinal" => "1213" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3933810" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0285" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pad urine collection for early childhood urinary-tract infection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P.I. Macfarlane" 1 => "C. Houghton" 2 => "C. Hughes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(99)02728-2" "Revista" => array:5 [ "tituloSerie" => "Lancet" "fecha" => "1999" "volumen" => "354" "paginaInicial" => "571" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10470711" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0290" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bolsa perineal versus sondaje uretral o punción suprapúbica para el diagnóstico de infección urinaria en el lactante en las unidades de urgencias" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.J. Martín Puerto" 1 => "M.E. Cela de Julián" 2 => "A. Mendoza Soto" 3 => "J. Sánchez del Pozo" 4 => "J.T. Ramos Amador" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "An Esp Pediatr" "fecha" => "1999" "volumen" => "50" "paginaInicial" => "447" "paginaFinal" => "450" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10394180" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0295" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Catch or bag your specimen" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "I. McKune" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Nurs Times" "fecha" => "1989" "volumen" => "85" "paginaInicial" => "80" "paginaFinal" => "82" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2813123" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0300" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidencia de infección urinaria en lactantes hospitalizados según método de recolección de la muestra para examen simple de orina" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Méndez" 1 => "M. Orellana" 2 => "F. Simoes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Venez Pueric Pediatr" "fecha" => "2003" "volumen" => "66" "paginaInicial" => "2" "paginaFinal" => "17" ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0305" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Choice of urine collection methods for the diagnosis of urinary tract infection in young, febrile infants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.R. Schroeder" 1 => "T.B. Newman" 2 => "R.C. Wasserman" 3 => "S.A. Finch" 4 => "R.H. Pantell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archpedi.159.10.915" "Revista" => array:6 [ "tituloSerie" => "Arch Pediatr Adolesc Med" "fecha" => "2005" "volumen" => "159" "paginaInicial" => "915" "paginaFinal" => "922" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16203935" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0310" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contamination rates of different urine collection methods for the diagnosis of urinary tract infections in young children: an observational cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Tosif" 1 => "A. Baker" 2 => "E. Oakley" 3 => "S. Donath" 4 => "F.E. Babl" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1440-1754.2012.02449.x" "Revista" => array:6 [ "tituloSerie" => "J Paediatr Child Health" "fecha" => "2012" "volumen" => "48" "paginaInicial" => "659" "paginaFinal" => "664" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22537082" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0315" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A head-to-head comparison: clean-void bag versus catheter urinalysis in the diagnosis of urinary tract infection in young children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. McGillivray" 1 => "E. Mok" 2 => "E. Mulrooney" 3 => "M.S. Kramer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpeds.2005.05.007" "Revista" => array:6 [ "tituloSerie" => "J Pediatr" "fecha" => "2005" "volumen" => "147" "paginaInicial" => "451" "paginaFinal" => "456" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16227029" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0320" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nosocomial rotavirus infections: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Bruijning-Verhagen" 1 => "C. Quach" 2 => "M. Bonten" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2011-2779" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2012" "volumen" => "129" "paginaInicial" => "e1011" "paginaFinal" => "e1019" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22392170" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0325" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MRSA nasal colonization in children: prevalence meta-analysis, review of risk factors and molecular genetics" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Gesualdo" 1 => "D. Bongiorno" 2 => "C. Rizzo" 3 => "A. Bella" 4 => "D. Menichella" 5 => "S. Stefani" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/INF.0b013e3182864e4c" "Revista" => array:6 [ "tituloSerie" => "Pediatr Infect Dis J" "fecha" => "2013" "volumen" => "32" "paginaInicial" => "479" "paginaFinal" => "485" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23340553" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0330" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of fetal alcohol spectrum disorders in child care settings: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Lange" 1 => "K. Shield" 2 => "J. Rehm" 3 => "S. Popova" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2013-0066" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2013" "volumen" => "132" "paginaInicial" => "e980" "paginaFinal" => "e995" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24019412" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0335" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of anxiety and depressive symptoms in adolescents with asthma: a meta-analysis and meta-regression" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Y. Lu" 1 => "K-K. Mak" 2 => "H.P.S. van Bever" 3 => "T.P. Ng" 4 => "A. Mak" 5 => "R.C-M. Ho" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/pai.12000" "Revista" => array:6 [ "tituloSerie" => "Pediatr Allergy Immunol" "fecha" => "2012" "volumen" => "23" "paginaInicial" => "707" "paginaFinal" => "715" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22957535" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0340" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Parental underestimates of child weight: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Lundahl" 1 => "K.M. Kidwell" 2 => "T.D. Nelson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2013-2690" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2014" "volumen" => "133" "paginaInicial" => "e689" "paginaFinal" => "e703" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24488736" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0345" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Electrocardiogram screening for disorders that cause sudden cardiac death in asymptomatic children: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.M. Rodday" 1 => "J.K. Triedman" 2 => "M.E. Alexander" 3 => "J.T. Cohen" 4 => "S. Ip" 5 => "J.W. Newburger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2011-0643" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2012" "volumen" => "129" "paginaInicial" => "e999" "paginaFinal" => "e1010" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22392183" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0350" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence and prevalence of eosinophilic esophagitis in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "I.S. Soon" 1 => "J.D. Butzner" 2 => "G.G. Kaplan" 3 => "J.C.C. deBruyn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MPG.0b013e318291fee2" "Revista" => array:6 [ "tituloSerie" => "J Pediatr Gastroenterol Nutr" "fecha" => "2013" "volumen" => "57" "paginaInicial" => "72" "paginaFinal" => "80" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23539047" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000008400000002/v1_201601300058/S2341287915002100/v1_201601300058/en/main.assets" "Apartado" => array:4 [ "identificador" => "26005" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008400000002/v1_201601300058/S2341287915002100/v1_201601300058/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287915002100?idApp=UINPBA00005H"]

Statistics

Original Article

Systematic review of the validity of urine cultures collected by sterile perineal bags

Revisión sistemática de la validez de los urocultivos recogidos con bolsa estéril perineal

C. Ochoa Sangrador

Corresponding author

cochoas2@gmail.com

Corresponding author.

, A. Pascual Terrazas

Servicio de Pediatría, Complejo Asistencial de Zamora y Escuela Universitaria de Enfermería de Zamora, Zamora, Spain

Read

8688

Times
was read the article

2583

Total PDF

6105

Total HTML

Share statistics

 array:24 [
  "pii" => "S2341287915002100"
  "issn" => "23412879"
  "doi" => "10.1016/j.anpede.2015.10.011"
  "estado" => "S300"
  "fechaPublicacion" => "2016-02-01"
  "aid" => "1862"
  "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
  "copyrightAnyo" => "2015"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "An Pediatr &#40;Barc&#41;. 2016;84:97-105"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 2735
    "formatos" => array:3 [
      "EPUB" => 171
      "HTML" => 1949
      "PDF" => 615
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S1695403315001423"
      "issn" => "16954033"
      "doi" => "10.1016/j.anpedi.2015.04.003"
      "estado" => "S300"
      "fechaPublicacion" => "2016-02-01"
      "aid" => "1862"
      "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "An Pediatr &#40;Barc&#41;. 2016;84:97-105"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 5928
        "formatos" => array:3 [
          "EPUB" => 157
          "HTML" => 4802
          "PDF" => 969
        ]
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
        "titulo" => "Revisi&#243;n sistem&#225;tica de la validez de los urocultivos recogidos con bolsa est&#233;ril perineal"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "97"
            "paginaFinal" => "105"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Systematic review of the validity of urine cultures collected by sterile perineal bags"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0015"
            "etiqueta" => "Figura 3"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr3.jpeg"
                "Alto" => 1517
                "Ancho" => 2642
                "Tamanyo" => 265582
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Sensibilidad y especificidad&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "C&#46; Ochoa Sangrador, A&#46; Pascual Terrazas"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Ochoa Sangrador"
              ]
              1 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Pascual Terrazas"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2341287915002100"
          "doi" => "10.1016/j.anpede.2015.10.011"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287915002100?idApp=UINPBA00005H"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315001423?idApp=UINPBA00005H"
      "url" => "/16954033/0000008400000002/v1_201601280025/S1695403315001423/v1_201601280025/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2341287915002082"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2015.10.009"
    "estado" => "S300"
    "fechaPublicacion" => "2016-02-01"
    "aid" => "1859"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2016;84:106-13"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2422
      "formatos" => array:3 [
        "EPUB" => 125
        "HTML" => 1791
        "PDF" => 506
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Validation of the Spanish version of the Parent&#39;s Postoperative Pain Management pain scale"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "106"
          "paginaFinal" => "113"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Validaci&#243;n de la versi&#243;n espa&#241;ola de la escala de evaluaci&#243;n del dolor postoperatorio Parent&#39;s Postoperative Pain Managament"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46;M&#46; Ullan, M&#46; Perell&#243;, C&#46; Jerez, E&#46; G&#243;mez, M&#46;J&#46; Planas, N&#46; Serrallonga"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "A&#46;M&#46;"
              "apellidos" => "Ullan"
            ]
            1 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Perell&#243;"
            ]
            2 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Jerez"
            ]
            3 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "G&#243;mez"
            ]
            4 => array:2 [
              "nombre" => "M&#46;J&#46;"
              "apellidos" => "Planas"
            ]
            5 => array:2 [
              "nombre" => "N&#46;"
              "apellidos" => "Serrallonga"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403315001241"
        "doi" => "10.1016/j.anpedi.2015.04.001"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315001241?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287915002082?idApp=UINPBA00005H"
    "url" => "/23412879/0000008400000002/v1_201601300058/S2341287915002082/v1_201601300058/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2341287915002136"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2015.10.014"
    "estado" => "S300"
    "fechaPublicacion" => "2016-02-01"
    "aid" => "1866"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2016;84:92-6"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2710
      "formatos" => array:3 [
        "EPUB" => 144
        "HTML" => 1938
        "PDF" => 628
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Combination of pulsed dye laser and propranolol in the treatment of ulcerated infantile haemangioma"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "92"
          "paginaFinal" => "96"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Combinaci&#243;n de propranolol oral y l&#225;ser de colorante pulsado en el tratamiento de los hemangiomas infantiles ulcerados"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 676
              "Ancho" => 900
              "Tamanyo" => 97264
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Patient with ulcerated haemangioma in the nappy area&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46; Rodr&#237;guez-Ruiz, M&#46;G&#46; Tellado, J&#46; del Pozo Losada"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Rodr&#237;guez-Ruiz"
            ]
            1 => array:2 [
              "nombre" => "M&#46;G&#46;"
              "apellidos" => "Tellado"
            ]
            2 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "del Pozo Losada"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403315001460"
        "doi" => "10.1016/j.anpedi.2015.04.007"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315001460?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287915002136?idApp=UINPBA00005H"
    "url" => "/23412879/0000008400000002/v1_201601300058/S2341287915002136/v1_201601300058/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
    "titulo" => "Systematic review of the validity of urine cultures collected by sterile perineal bags"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "97"
        "paginaFinal" => "105"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "C&#46; Ochoa Sangrador, A&#46; Pascual Terrazas"
        "autores" => array:2 [
          0 => array:4 [
            "nombre" => "C&#46;"
            "apellidos" => "Ochoa Sangrador"
            "email" => array:1 [
              0 => "cochoas2&#64;gmail&#46;com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "A&#46;"
            "apellidos" => "Pascual Terrazas"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Pediatr&#237;a&#44; Complejo Asistencial de Zamora y Escuela Universitaria de Enfermer&#237;a de Zamora&#44; Zamora&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Revisi&#243;n sistem&#225;tica de la validez de los urocultivos recogidos con bolsa est&#233;ril perineal"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 3143
            "Ancho" => 2415
            "Tamanyo" => 366803
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Proportion of false positives&#46; 95&#37; CI&#58; 95&#37; confidence interval&#59; Prev&#58; proportion or prevalence&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Urinary tract infection &#40;UTI&#41; in paediatric patients is one of the most frequent causes of visits in the health care system&#44; in Primary Care as well as in the emergency room&#44; and it is a frequent cause of hospitalisation&#46; In children&#44; urinary tract infection symptoms are usually unspecific&#44; such as fever without a source&#44; food rejection or failure to thrive&#46; That is why diagnostic confirmation with a urine culture is particularly important&#46; Diagnostic methods must be quick and sensitive enough to facilitate prompt treatment and lower mortality rates&#44; but specific enough to avoid unnecessary complementary tests and therapies&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Currently&#44; we have several techniques for the collection of urine samples from children&#46; When the child has bladder control&#44; the technique usually employed is the collection of urine from the urinary stream&#46; In children who do not have bladder control&#44; the most widely used method is the perineal adhesive bag&#44; even though samples collected with this technique have a high risk of contamination or false positives&#46; Samples collected through bladder catheterisation or suprapubic aspiration have a lower risk of contamination&#44; but these are invasive&#44; potentially risky techniques&#46; Therefore&#44; they are used as confirmatory tests or in emergency situations in which an immediate diagnosis or treatment is required&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">1&#44;2</span></a> The use of sterile compresses&#44; a technique employed in other countries&#44; is uncommon in Spain&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Several technical reports and clinical practice guidelines mention studies that show the limitations of the perineal bag for urine culture collection&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">1&#44;3&#8211;5</span></a> However&#44; no review studies have as yet quantified the principle problems associated with this sampling technique&#58; the high risk of contamination and false positives&#46; Our objective is to perform a systematic review to estimate the validity of samples collected with a perineal bag as a basis for clinical practice guidelines&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Bibliographic search</span><p id="par0020" class="elsevierStylePara elsevierViewall">The PUBMED&#44; SCOPUS &#40;including PUBMED and EMBASE&#41; CINHAL&#44; IBECS and CUIDEN databases were searched for articles published up to May 2014&#44; with no restrictions on type of study&#44; language&#44; or year of publication&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">For PUBMED&#44; SCOPUS and CINHAL&#44; 2 search strategies were employed&#58; 1 extensive search using the string &#40;&#8220;infant&#8221;&#91;MeSH Terms&#93; OR &#8220;child&#8221;&#91;MeSH Terms&#93;&#41; AND &#40;&#8220;Urinary tract infections&#8221;&#91;MeSh&#93; OR &#40;&#8220;Urine&#8221; AND &#8220;Culture&#8221;&#41; OR &#40;Urinary AND Infection&#41;&#41; AND &#40;&#8220;Specimen Handling&#8221;&#91;MeSh&#93; OR Specim&#42; OR &#8220;Urine Specimen Collection&#8221;&#91;Mesh&#93; OR &#8220;Bag&#8221; OR &#8220;Bags&#8221;&#41; AND &#40;&#8220;Urine&#47;microbiology&#8221;&#91;Mesh&#93; OR &#8220;Contamination&#8221; OR &#8220;false positive&#8221; OR &#8220;Diagnosis&#8221;&#91;Mesh&#93; OR &#8220;Sensitivity and Specificity&#8221;&#91;Mesh&#93;&#8221;&#59; and 1 simplified search using &#40;&#8220;infant OR child&#8221;&#41; AND &#8220;urine&#8221; AND &#8220;specimen handling&#8221;&#46; In IBECS and CUIDEN&#44; the equivalent terms in Spanish were employed&#46; The references from the recovered studies were examined to identify other undetected studies&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">A total of 935 references were identified in the searches performed after the exclusion of duplicates&#46; The titles and summaries of these references were reviewed and 40 full-text articles were selected&#46; The references from the recovered articles were examined and 7 supplementary articles unidentified in the initial searches were found&#46; The 47 recovered studies were examined to assess their inclusion in the review&#46; The entire search and review process was performed in duplicate&#46; Disagreements on criteria among the reviewers were resolved by consensus&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Study selection criteria</span><p id="par0035" class="elsevierStylePara elsevierViewall">The studies selected were diagnostic test assessments&#44; unlimited by design&#44; language and date&#44; that analysed urine samples for culture collected using a perineal bag from ambulatory or hospitalised paediatric patients of both genders with suspicion or at risk of UTI &#40;excluding studies in healthy children&#41;&#46; The studies had to include the number or percentage of contaminated samples &#40;according to specified microbiological criteria&#41; or false positives &#40;positive urine culture with bag unconfirmed by urine cultures performed via suprapubic aspiration or bladder catheterisation&#41;&#46; Studies with data that enabled the estimation of the sensitivity and specificity of urine cultures collected via perineal bag in comparison with urine cultures collected via bladder catheterisation or suprapubic aspiration were also included&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Data extraction and quality assessment</span><p id="par0040" class="elsevierStylePara elsevierViewall">From each study&#44; information on sample size&#44; country&#44; area &#40;hospital&#44; emergency department or ambulatory patient&#41;&#44; patient characteristics &#40;age and sex&#41;&#44; inclusion and exclusion criteria&#44; assessed tests&#44; assessment criteria&#44; data &#40;contaminated samples&#44; true positives&#44; false positives&#44; false negatives and true positives&#41;&#44; other results&#44; quality and limitations were extracted in duplicate&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The quality criteria assessed were&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8211;</span><p id="par0050" class="elsevierStylePara elsevierViewall">Well-defined test or strategy&#58; the information provided facilitates reproducibility&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8211;</span><p id="par0055" class="elsevierStylePara elsevierViewall">Valid assessment criterion&#58; enables the culture to be classified correctly as contaminated&#44; negative or positive&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8211;</span><p id="par0060" class="elsevierStylePara elsevierViewall">Representative sample&#58; similar to the patient population found in clinical practice &#40;no biased selection of positive samples or exclusion of contaminated samples&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#8211;</span><p id="par0065" class="elsevierStylePara elsevierViewall">Independent comparison&#58; the test assessment or interpretation and the assessment criterion are independent and objective&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#8211;</span><p id="par0070" class="elsevierStylePara elsevierViewall">Diagnostic verification and incorporation bias control&#58; the first one occurs when the reference test is performed with higher or lower likelihood according to the result of the diagnostic test to be assessed&#44; and the second occurs when the diagnostic test result is part of the assessment criterion &#40;e&#46;g&#46;&#44; positive urine cultures collected via bag are considered UTIs&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">&#8211;</span><p id="par0075" class="elsevierStylePara elsevierViewall">Correct analysis&#58; enough information is provided so that unbiased percentages of contaminated urines&#44; false positives&#44; sensitivity and specificity can be calculated&#46;</p></li></ul></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical analysis</span><p id="par0080" class="elsevierStylePara elsevierViewall">A grouped analysis was performed for the percentages of contaminated and false positives&#44; assuming random-effects models&#46; The calculations and charts were generated with the MetaXL utility for Excel &#40;EpiGear International Pty Ltd&#41;&#46; For the calculation of grouped validity measures &#40;sensitivity and specificity&#41;&#44; the programme MetaDiSc &#40;ES&#41; v&#46;1&#46;1&#46;1 was employed&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">6</span></a> Heterogeneity indicators &#40;Cochrane&#39;s Q &#38; <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span>&#41; and 95&#37; confidence intervals &#40;95&#37; CI&#41; were estimated for all the parameters&#46; Tests for heterogeneity &#40;Dersimonian and Laird&#41; publication bias &#40;Begg and Egger&#41; and sensitivity &#40;excluding individual studies&#41; were performed&#46; Analyses of subgroups&#44; meta-regressions &#40;geographical area and representative sample&#41;&#44; Galbraith charts&#44; cumulative and sensitivity charts were performed&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><p id="par0085" class="elsevierStylePara elsevierViewall">Out of the 47 full-text articles examined&#44; 21 that complied with the inclusion criteria were selected&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">7&#8211;27</span></a> The purpose of most of the studies included was to determine the validity of the perineal bag versus other techniques through different estimators&#46; In 15 studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">7&#44;12&#8211;14&#44;16&#8211;18&#44;21&#44;22&#44;24&#8211;27</span></a> contaminated samples were estimated&#44; and in 12<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">9&#44;15&#8211;17&#44;19&#44;20&#44;23&#44;25</span></a> false positives were estimated&#46; The validity related to an external reference pattern was determined in only 5 studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">9&#44;11&#44;13&#44;16&#44;17</span></a> One article was excluded because it analysed urine samples by a test strip and not by culture&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">28</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the simplified characteristics of the 21 studies included in the meta-analysis&#46; The studies were carried out in different countries&#44; but their assessment methods and characteristics were very similar&#46; They included a total of 14&#44;759 patients&#44; 7659 with urine bag samples&#46; The ages of the children included in the study are similar&#44; between 1 day and 3 years of age&#44; except for some studies that included some older patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">11&#44;14</span></a> The children included had clinical symptoms &#40;most of them with fever without source&#41;&#44; suspicion of UTI&#44; or prior positive cultures using a non-sterile urine collection technique&#46; Gender-specific variables are specified in 5 studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">8&#44;11&#44;12&#44;17&#44;23</span></a> with a discrete higher frequency of girls&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the quality assessment of all the studies included in the meta-analysis&#46; The assessment criteria employed for sample contamination or sample positivity&#47;negativity is appropriate&#44; although only one third of the studies use a complete reference pattern for all the samples&#46; In half of the studies&#44; the sample presents some type of bias&#44; mainly in those that assessed sensitivity and specificity&#44; since the analyses do not include contaminated samples&#46; In other studies&#44; the sample includes an over-representation of patients with previously positive urines&#46; None of the studies detail procedures that guarantee the independent or blind assessment of the compared tests&#44; although culture interpretation is a relatively objective test&#46; The biased incorporation of bag samples with positive culture is common in several studies&#46; Finally&#44; all the studies included offer data that enable a correct analysis&#44; although a complete validity assessment can be performed in only one quarter of studies&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1 and 2</a> show the meta-analysis of contaminated samples and false positives with perineal bag&#46; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the pooled measurements for perineal bag and those of other samples analysed in the studies reviewed&#46; For urine collected with the bag&#44; the weighted percentage of contaminated urines is 46&#46;6&#37;&#44; and for false positives 61&#46;1&#37;&#46; In the meta-regression analyses&#44; we found that studies with representative patient samples had a significantly lower percentage of false positives&#59; therefore&#44; we performed a meta-analysis by subgroups&#46; All the analyses show important heterogeneity &#40;<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>50&#37;&#41;&#44; although we were unable to identify a particular study that&#44; when excluded&#44; would reduce heterogeneity&#46; The publication bias tests &#40;Begg and Egger&#41; showed no statistical significance&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">In two studies<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">8&#44;17</span></a> the data from boys and girls was estimated separately&#44; showing a higher risk of contaminated urine in boys &#40;38&#46;9&#37; vs 29&#46;2&#37;&#59; odds ratio &#91;OR&#93; 1&#46;53&#59; 95&#37; CI&#58; 1&#46;36&#8211;1&#46;72&#41;&#46; The same was done for false positives in 4 studies&#44; and no significant differences were found &#40;OR&#58; 0&#46;96&#59; 95&#37; CI&#58; 0&#46;25&#8211;3&#46;65&#41;&#46; For samples collected via urinary stream and bladder catheterisation&#44; the risks of contaminated urine or false positives are clearly lower&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a> shows the meta-analysis for validity indicators of culture with perineal bag in comparison with the sterile technique&#46; The weighted specificity and sensitivity are 82&#37; and 88&#37;&#44; respectively&#46; These estimates do not present heterogeneity&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0115" class="elsevierStylePara elsevierViewall">Although the use of urine collection for culture via perineal bag is widespread&#44; the available evidence indicates that it is not a very valid method due to the high risk of contaminated samples and false positives&#46; The studies retrieved from the bibliographic search&#44; however&#44; are extremely heterogeneous&#59; therefore&#44; these findings could be inexact&#46; Although the heterogeneity observed could be unacceptable for relative risk measurements&#44; it is common to find rates of over 90&#37; in meta-analyses of prevalence studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">29&#8211;35</span></a> In fact&#44; in risk meta-analyses&#44; the baseline prevalence differences between studies&#44; which are partially compensated by the relative measurements&#44; are one of the main heterogeneity determinants&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Even the most optimistic estimates show that this urine collection technique is unreliable&#46; The fact that 1 out of every 2 urine cultures collected with a perineal bag is contaminated or gives a false positive compromises the usefulness of the technique&#44; or should at least make us question the validity of its results&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The high percentages of contamination and false positives are related to the collection procedure&#44; i&#46;e&#46;&#44; cleanliness&#44; placement and replacement of the perineal bag&#46; The risk of contamination varies depending on the meticulousness of the procedure followed&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">10</span></a> Based on our results&#44; the risk of urine contamination in children is somewhat higher&#44; although it is unacceptably high in both cases&#46; Although the percentage of false positives is lower in the studies in which the samples do not include an over-representation of patients with prior positive urine cultures&#44; it is&#44; in any case&#44; very high&#46; These studies were not excluded from the meta-analysis because it is common for new samples for culture to be collected from children with prior positive urine cultures &#40;with bag&#41;&#46; This tends to overestimate the positive cases in the samples&#44; but it should not affect the confirmation percentage &#40;false positives&#41; of reference techniques&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">It is surprising to observe that the 5 studies assessing the validity of sterile collection techniques found them to have a sensitivity and specificity of over 80&#37;&#46; It is evident that the exclusion of contaminated samples &#40;which are neither positive nor negative&#44; and are common in clinical practice&#41; from the validity analysis would bias the estimation&#46; Nevertheless&#44; we cannot rule out the existence of certain settings and patient populations in which these results would be valid if strict hygiene measures are enforced&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">The results of this review show the limitations of the studies included&#46; Most of them are of medium quality&#44; since none include such an important criterion as the blind or independent assessment of the diagnostic test and the reference criterion&#46; In addition&#44; the patient samples included are not sufficiently representative due to bias in the inclusion of samples previously positive or contaminated&#46; Likewise&#44; it is surprising that most of the studies are carried out in the hospital environment&#44; although many of the children with UTI symptoms are seen at primary care clinics&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Although different documents and clinical practice guidelines already recommend the use of other urine collection techniques when a reliable diagnosis is essential&#44;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">1&#44;2</span></a> the findings of this review quantify the importance and significance of this recommendation&#46; Considering the high risk of contamination&#44; the perineal bag cannot be used to collect a sample for culture in a high-risk patient requiring immediate antibiotic treatment&#46; A finding of contaminated urine will not confirm or rule out infection&#44; and a positive finding runs a high risk of being false&#46; Also&#44; the antibiotic administered would interfere with the validity of the new urine sample that would have to be collected to confirm diagnosis&#46; The diagnostic uncertainty would affect not only treatment but also the decision to perform further diagnostic tests or follow-up studies&#46; The iatrogenic cascade triggered by each wrong diagnosis must also be considered&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">In low-risk patients&#44; in whom diagnosis is unlikely and treatment delay acceptable&#44; we could collect the urine with a bag and wait for the result&#46; The less invasive character and ease of this technique have made it the gold standard in our clinical practice&#46; However&#44; it is important to bear in mind that only negative results will be acceptable because the positive ones will most likely be false and will have to be confirmed with more valid urine collection techniques &#40;bladder catheterisation or suprapubic aspiration&#41;&#46; This recommendation&#44; included in consensus documents&#44;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">1&#44;2</span></a> is pragmatic&#44; even assuming that meticulous cleaning&#44; placement and replacement of the bag will minimise the drawbacks of this urine collection technique&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">We conclude that the perineal adhesive bag is not a sufficiently valid method for collecting urine for culture&#44; since almost half of the cultures will be contaminated and 2 out of 3 positives will be false&#46; Even though the estimates are inaccurate&#44; due to the heterogeneity of the studies available&#44; they must be considered when choosing the urine collection method&#46; The sensitivity and specificity estimates are not applicable since they do not take into account the risk of contamination&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflict of interest</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors declare that there are no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:10 [
        0 => array:3 [
          "identificador" => "xres600569"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusion"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec614813"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres600570"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusi&#243;n"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec614814"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Material and methods"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Bibliographic search"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Study selection criteria"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Data extraction and quality assessment"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Conflict of interest"
        ]
        9 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2015-02-24"
    "fechaAceptado" => "2015-04-08"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec614813"
          "palabras" => array:5 [
            0 => "Urinary tract infections"
            1 => "Urine&#47;microbiology"
            2 => "Urine specimen collection"
            3 => "Sensitivity and specificity"
            4 => "Meta-analysis"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec614814"
          "palabras" => array:5 [
            0 => "Infecci&#243;n urinaria"
            1 => "Orina&#47;microbiolog&#237;a"
            2 => "Recogida de muestra de orina"
            3 => "Sensibilidad y especificidad"
            4 => "Metaan&#225;lisis"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The perineal adhesive bag is the most commonly used method in our country for urine culture collection in infants&#44; despite having a high risk of contamination and false-positive results&#46; We aim to quantify both types of risks through a systematic review&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Search updated in May 2014 in PUBMED&#44; SCOPUS &#40;includes EMBASE&#41;&#44; IBECS&#59; CINAHL&#44; LILACS AND CUIDEN&#44; unrestricted by language or date&#46; Percentage of contaminated samples&#44; false positives&#44; sensitivity and specificity &#40;with respect to catheterization or bladder puncture&#41; were recorded&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 21 studies of medium quality &#40;7659 samples&#41; were selected&#46; The pooled percentage of contaminated samples was 46&#46;6&#37; &#40;15 studies&#59; 6856 samples&#59; 95&#37; confidence interval &#91;95&#37; CI&#93;&#58; 35&#46;6&#8211;57&#46;8&#37;&#59; <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span>&#58; 97&#46;3&#37;&#41;&#46; The pooled percentage of false positives was 61&#46;1&#37; &#40;12 studies&#59; 575 samples&#59; 95&#37; CI&#58; 37&#46;9&#8211;82&#46;2&#37;&#59; <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span>&#58; 96&#46;2&#37;&#41;&#46; Sensitivity &#40;88&#37;&#59; 95&#37; CI&#58; 81&#8211;93&#37;&#59; <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span>&#58; 55&#46;2&#37;&#41; and specificity &#40;82&#37;&#59; 95&#37; CI&#58; 75&#8211;89&#37;&#59; <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span>&#58; 41&#46;3&#37;&#41; were estimated in five studies&#44; but without including contaminated samples&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The perineal adhesive bag is not a valid enough method for urine culture collection&#44; because almost half of all samples are contaminated&#44; and two out of three positives are false&#46; Although these estimates are imprecise&#44; because of their great heterogeneity&#44; they should be considered when choosing the method of urine collection&#46; The estimates of sensitivity and specificity are not applicable because they do not take into account the risk of contamination&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusion"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La bolsa adhesiva perineal es el m&#233;todo m&#225;s usado en nuestro medio para la recogida de orina para cultivo en el lactante&#44; a pesar de que presenta un alto riesgo de contaminaci&#243;n y de resultados falsos positivos&#46; Nos proponemos cuantificar ambos riesgos a trav&#233;s de una revisi&#243;n sistem&#225;tica&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">B&#250;squeda actualizada a mayo del 2014 en PUBMED&#44; SCOPUS &#40;incluye EMBASE&#41;&#44; IBECS&#59; CINHAL&#44; LILACS Y CUIDEN&#44; sin l&#237;mites de idioma ni tiempo&#46; Se extrajeron porcentajes de orinas contaminadas&#44; falsos positivos&#44; sensibilidad y especificidad &#40;respecto cateterismo o punci&#243;n vesical&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se seleccionaron 21 art&#237;culos de calidad media &#40;7&#46;659 muestras&#41;&#46; El porcentaje agrupado de orinas contaminadas fue del 46&#44;6&#37; &#40;15 estudios&#59; 6&#46;856 muestras&#59; intervalo de confianza del 95&#37; &#91;IC del 95&#37;&#93;&#44; 35&#44;6 a 57&#44;8&#37;&#59; I<span class="elsevierStyleSup">2</span>&#58; 97&#44;3&#37;&#41;&#46; El porcentaje agrupado de falsos positivos fue del 61&#44;1&#37; &#40;12 estudios&#59; 575 muestras&#59; IC del 95&#37;&#44; 37&#44;9 a 82&#44;2&#37;&#59; I<span class="elsevierStyleSup">2</span>&#58; 96&#44;2&#37;&#41;&#46; En 5 estudios se pudieron estimar la sensibilidad &#40;88&#37;&#59; IC del 95&#37;&#44; 81 a 93&#37;&#59; I<span class="elsevierStyleSup">2</span>&#58; 55&#44;2&#37;&#41; y especificidad &#40;82&#37;&#59; IC del 95&#37;&#44; 75 a 89&#37;&#59; I<span class="elsevierStyleSup">2</span>&#58; 41&#44;3&#37;&#41;&#44; aunque en los recuentos no se incluyeron orinas contaminadas&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La bolsa adhesiva perineal no es un m&#233;todo suficientemente v&#225;lido para cultivo de orina porque casi la mitad resultar&#225;n contaminados y de los positivos 2 de cada 3 ser&#225;n falsos&#46; Aun siendo estimaciones imprecisas&#44; por su gran heterogeneidad&#44; deben ser tenidas en cuenta en la elecci&#243;n del m&#233;todo de recogida de orina&#46; Las estimaciones de sensibilidad y especificidad no son aplicables por no considerar el riesgo de contaminaci&#243;n&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Please cite this article as&#58; Ochoa Sangrador C&#44; Pascual Terrazas A&#46; Revisi&#243;n sistem&#225;tica de la validez de los urocultivos recogidos con bolsa est&#233;ril perineal&#46; An Pediatr &#40;Barc&#41;&#46; 2016&#59;84&#58;97&#8211;105&#46;</p>"
      ]
    ]
    "multimedia" => array:6 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2236
            "Ancho" => 2263
            "Tamanyo" => 287977
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Proportion of contaminated samples&#46; 95&#37; CI&#58; 95&#37; confidence interval&#59; Prev&#58; proportion or prevalence&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 3143
            "Ancho" => 2415
            "Tamanyo" => 366803
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Proportion of false positives&#46; 95&#37; CI&#58; 95&#37; confidence interval&#59; Prev&#58; proportion or prevalence&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1555
            "Ancho" => 2616
            "Tamanyo" => 265655
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Sensitivity and specificity&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Catheter&#58; bladder catheterisation&#59; stream&#58; urinary stream&#59; compress&#58; sterile compress&#59; NA&#58; not applicable&#59; NS&#58; not stated&#59; aspiration&#58; suprapubic aspiration&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Study&#46; Country&#59; scope&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Number &#40;bag&#41;&#59; age<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sample assessed &#40;&#43;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Contamination criterion<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Reference criterion &#40;&#43;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Positive<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">e</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Al Orifi 2000&#46; Canada&#59; Emergency department&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7584 &#40;5127&#41;&#59; &#8804;24 months &#40;NS&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag &#40;&#8805;10<span class="elsevierStyleSup">4</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed or 1 organism &#40;10<span class="elsevierStyleSup">3</span>&#8211;10<span class="elsevierStyleSup">4</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Alam 2005&#46; Brazil&#59; hospital &#40;admission&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">191 &#40;169&#41;&#59; &#60;3 years &#40;admitted&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag&#44; compress or stream &#40;&#8805;10<span class="elsevierStyleSup">5</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed or &#60;10<span class="elsevierStyleSup">5</span> only 2 methods&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Benito 1996&#46; Spain&#59; Emergency department&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61 &#40;61&#41;&#59; &#60;1 year &#40;culture &#91;&#43;&#93; or clinical symptoms&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag &#40;&#8805;10<span class="elsevierStyleSup">5</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Undefined&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Aspiration &#40;&#62;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Biassini 1974&#46; Italy&#59; hospital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">404 &#40;152&#41;&#59; newborn &#40;suspicion of bacteriuria&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag in supine or prone&#44; stream &#40;&#8805;10<span class="elsevierStyleSup">4</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;10<span class="elsevierStyleSup">3</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">If confirmed in 3 samples &#40;bag or stream&#41; aspiration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Braude 1967&#46; United Kingdom&#59; NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68 &#40;16&#41;&#59; 9 days to 11 years &#40;UTI clinical symptoms&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag&#44; stream &#40;&#8805;10<span class="elsevierStyleSup">4</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Undefined&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Catheter &#40;&#8805;10<span class="elsevierStyleSup">4</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Conn 1970&#46; United Kingdom&#59; hospital &#40;admission&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">152 &#40;56&#41;&#59; &#60;3 years &#40;suspicion of UTI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag&#44; stream &#40;&#8805;10<span class="elsevierStyleSup">4</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Aspiration &#40;&#8805;10<span class="elsevierStyleSup">4</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#46;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Etoubleau 2009&#46; France&#59; Emergency department&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">192 &#40;192&#41;&#59; &#60;3 years &#40;fever&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag &#40;&#8805;10<span class="elsevierStyleSup">5</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Catheter &#40;&#8805;10<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Feasey 1999&#46; United Kingdom&#59; hospital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 &#40;50&#41;&#59; 1 day to 5 years &#40;UTI clinical symptoms&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag&#44; compress &#40;&#8805;10<span class="elsevierStyleSup">5</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed to one &#40;&#60;10<span class="elsevierStyleSup">5</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Gilljam 2008&#46; Sweden&#59; Emergency department&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61 &#40;61&#41;&#59; &#60;2 years &#40;prior &#91;&#43;&#93; culture&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag &#40;&#8805;10<span class="elsevierStyleSup">5</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Undefined&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Catheter &#40;&#8805;10<span class="elsevierStyleSup">5</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">52&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Grisaru-Soen 2000&#46; Israel&#59; hospital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50 &#40;50&#41;&#59; &#60;18 months &#40;UTI or sepsis clinical symptoms&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag &#40;NS&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Aspiration &#40;NS&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#46;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Hardy 1976&#46; United Kingdom&#59; hospital &#40;admission&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;30&#41;&#59; 1 day to 3 years &#40;ITU clinical symptoms and prior culture &#91;&#43;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag&#44; stream &#40;&#8805;10<span class="elsevierStyleSup">5</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Aspiration &#40;&#62;10<span class="elsevierStyleSup">5</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Karacan 2010&#46; Turkey&#59; hospital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;067 &#40;517&#41;&#59; &#60;16 months &#40;UTI clinical symptoms&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag&#44; stream &#40;&#8805;10<span class="elsevierStyleSup">5</span>&#44;&#41; catheter &#40;&#62;10<span class="elsevierStyleSup">4</span>&#41; or aspiration &#40;&#62;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Undefined&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#46;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Leong 1976&#46; Singapore&#59; hospital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">174 &#40;174&#41;&#59; &#60;2 years &#40;2 prior &#91;&#43;&#93; cultures&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag&#44; stream &#40;&#8805;10<span class="elsevierStyleSup">5</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Aspiration &#40;&#8805;10<span class="elsevierStyleSup">5</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Li 2002&#46; China&#59; hospital &#40;office visit&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100 &#40;100&#41;&#59; 1&#8211;24 months &#40;prior UTI with prophylaxis&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag &#40;&#8805;10<span class="elsevierStyleSup">5</span>&#41; with nitrites and leukocytes or 2 culture &#91;&#43;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Second urine culture &#40;&#8722;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Aspiration &#40;Gram &#43; &#8805;1000 Gram &#8722;&#41; catheter &#40;&#62;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">MacDonald 1985&#46; Canada&#59; Hospital &#40;admission&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">262 &#40;204&#41;&#59; 1&#8211;24<span class="elsevierStyleHsp" style=""></span>m &#40;routine at admission&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag&#44; stream &#40;&#62;10<span class="elsevierStyleSup">5</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed or &#60;10<span class="elsevierStyleSup">5</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Macfarlane 1999&#46; United Kingdom&#59; hospital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">362 &#40;34&#41;&#59; &#60;2 years &#40;fever&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag&#44; compress&#44; stream &#40;NS&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Mart&#237;n Puerto 1999&#46; Spain&#59; Emergency department&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#40;42&#41;&#59; &#60;27 months &#40;2 cultures &#91;&#43;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag &#40;&#8805;10<span class="elsevierStyleSup">5</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Undefined&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Catheter &#40;&#8805;20&#44;000&#41; or aspiration &#40;&#62;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">McCune 1989&#46; United Kingdom&#59; hospital &#40;admission&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46 &#40;23&#41;&#59; NS &#40;admitted&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag&#44; stream&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">M&#233;ndez 2003&#46; Chile&#59; hospital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">198 &#40;198&#41;&#59; &#60;24 months &#40;culture &#8805;10<span class="elsevierStyleSup">4</span> at 24<span class="elsevierStyleHsp" style=""></span>h&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag &#40;&#8805;10<span class="elsevierStyleSup">5</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Aspiration &#40;&#62;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Schroeder 2005&#46; U S&#59; Emergency department&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3066 &#40;390&#41;&#59; &#60;3 months &#40;fever&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag &#40;&#8805;10<span class="elsevierStyleSup">5</span>&#44;&#41; catheter &#40;&#8805;10<span class="elsevierStyleSup">4</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed or &#60;10<span class="elsevierStyleSup">4</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Tosif 2012&#46; Australia&#59; hospital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">599 &#40;13&#41;&#59; &#60;2 years &#40;UTI clinical symptoms&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bag&#44; stream &#40;&#8805;10<span class="elsevierStyleSup">5</span>&#44;&#41; aspiration or catheter &#40;&#62;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab982575.png"
              ]
            ]
          ]
          "notaPie" => array:5 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Sample&#58; number of samples &#40;number of samples with bag&#41;&#44; age &#40;selection criterion&#41;&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Test assessed&#58; type of samples for culture &#40;positive criterion&#58; growth count for one micro-organism in ufc&#47;ml&#41;&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Contamination criterion&#58; mixed &#40;growth of more than one micro-organism&#41;&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "d"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Reference criterion&#58; type of sample and positive criterion &#40;cut-off point in cfu&#47;ml&#41;&#46;</p>"
            ]
            4 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "e"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Positive&#58; percentage of positives with the reference criterion or in its absence with positive criterion of the assessed sample&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the studies included in the meta-analysis&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">A&#58; well-defined test or strategy&#59; B&#58; valid assessment criterion&#59; C&#58; representative sample&#59; D&#58; independent comparison&#59; E&#58; diagnostic verification and incorporation bias control&#59; F&#58; correct analysis&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">D&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">E&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Al Orifi&#44; 2000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Alam&#44; 2005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Benito&#44; 1996&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Biassini&#44; 1974&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Braude&#44; 1967&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Conn&#44; 1970&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Etoubleau&#44; 2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Feasey&#44; 1999&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Gilljam&#44; 2008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Grisaru-Soen&#44; 2000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Hardy&#44; 1976&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Karacan&#44; 2010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Leong&#44; 1976&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Li&#44; 2002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">MacDonald&#44; 1985&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Macfarlane&#44; 1999&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Mart&#237;n Puerto&#44; 1999&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">McCune&#44; 1989&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">M&#233;ndez&#44; 2003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Schroeder&#44; 2005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Tosif&#44; 2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Partial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab982573.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Quality of the studies included in the meta-analysis&#46;</p>"
        ]
      ]
      5 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sample measure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Studies &#40;patients&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Heterogeneity <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> &#40;<span class="elsevierStyleItalic">p</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Contaminated urine</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Perineal bag&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;6856&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#46;6&#37; &#40;35&#46;6 to 57&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97&#46;3&#37; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#37; &#40;30 to 65&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Urinary stream&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;1305&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;5&#37; &#40;13&#46;1 to 31&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&#46;1&#37; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#37; &#40;14 to 29&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Bladder catheterisation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;3853&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;23&#37; &#40;5&#46;5 to 11&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&#46;8&#37; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#37; &#40;7 to 13&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">False positives</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Perineal bag&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;575&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#46;1&#37; &#40;37&#46;9 to 82&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96&#46;2&#37; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&#37; &#40;46 to 83&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Representative sample</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;177&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;2&#37; &#40;8&#46;9 to 61&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">90&#37; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&#37; &#40;14 to 69&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;398&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73&#46;6&#37; &#40;56&#46;6 to 87&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">90&#37; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71&#37; &#40;53 to 86&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Urinary stream&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;282&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#46;8&#37; &#40;8&#46;3 to 41&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">70&#37; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;018&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#37; &#40;14 to 49&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab982574.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Grouped meta-analysis results for contamination and false positives&#46; Weighed percentages with their 95&#37; confidence interval &#40;95&#37; CI&#41;&#44; heterogeneity &#40;<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span>&#41;&#44; Dersimonian and Laird contrast &#40;<span class="elsevierStyleItalic">p</span>&#41;&#44; medians and interquartile ranges &#40;IQR&#41;&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:35 [
            0 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Grupo de trabajo de la Gu&#237;a de Pr&#225;ctica Cl&#237;nica sobre Infecci&#243;n del Tracto Urinario en la Poblaci&#243;n Pedi&#225;trica&#46; Gu&#237;a de Pr&#225;ctica Cl&#237;nica sobre Infecci&#243;n del Tracto Urinario en la Poblaci&#243;n Pedi&#225;trica&#46; Plan de Calidad para el Sistema Nacional de Salud del Ministerio de Sanidad&#44; Pol&#237;tica Social e Igualdad&#46; Instituto Aragon&#233;s de Ciencias de la Salud&#59; 2011&#46; Gu&#237;as de Pr&#225;ctica Cl&#237;nica en el SNS&#58; I&#43;CS No 2009&#47;01&#46;"
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "M&#233;todos para la recogida de muestras de orina para urocultivo y perfil urinario"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Grupo Investigador del Proyecto"
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46; Ochoa Sangrador"
                            1 => "M&#46;F&#46; Brezmes Valdivieso"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2007"
                        "volumen" => "67"
                        "paginaInicial" => "442"
                        "paginaFinal" => "449"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Urinary tract infection&#58; Diagnosis&#44; treatment and long-term management of urinary tract infection in children&#46; National Collaborating Centre for Women&#39;s and Children&#39;s Health&#46; RCOG Press&#46; August 2007&#46; Surveillance Review October 2013&#46; Available at&#58; <a id="intr0010" class="elsevierStyleInterRef" href="http://www.nice.org.uk/nicemedia/pdf/CG54fullguideline.pdf">http&#58;&#47;&#47;www&#46;nice&#46;org&#46;uk&#47;nicemedia&#47;pdf&#47;CG54fullguideline&#46;pdf</a> &#91;accessed 11&#46;12&#46;14&#93;&#46;"
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Technical report&#8212;diagnosis and management of an initial UTI in febrile infants and young children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46;M&#46; Finnell"
                            1 => "A&#46;E&#46; Carroll"
                            2 => "S&#46;M&#46; Downs"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2011-1332"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2011"
                        "volumen" => "128"
                        "paginaInicial" => "e749"
                        "paginaFinal" => "e770"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21873694"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical effectiveness and cost-effectiveness of tests for the diagnosis and investigation of urinary tract infection in children&#58; a systematic review and economic model"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Whiting"
                            1 => "M&#46; Westwood"
                            2 => "L&#46; Bojke"
                            3 => "S&#46; Palmer"
                            4 => "G&#46; Richardson"
                            5 => "J&#46; Cooper"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Health Technol Assess"
                        "fecha" => "2006"
                        "volumen" => "10"
                        "paginaInicial" => "1"
                        "paginaFinal" => "172"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17134596"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meta-DiSc&#58; a software for meta-analysis of test accuracy data"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Zamora"
                            1 => "V&#46; Abraira"
                            2 => "A&#46; Muriel"
                            3 => "K&#46; Khan"
                            4 => "A&#46; Coomarasamy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1471-2288-6-31"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Med Res Methodol"
                        "fecha" => "2006"
                        "volumen" => "6"
                        "paginaInicial" => "31"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16836745"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of urine contamination rates using three different methods of collection&#58; clean-catch&#44; cotton wool pad and urine bag"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;T&#46; Alam"
                            1 => "J&#46;B&#46; Coulter"
                            2 => "J&#46; Pacheco"
                            3 => "J&#46;B&#46; Correia"
                            4 => "M&#46;G&#46; Ribeiro"
                            5 => "M&#46;F&#46; Coelho"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1179/146532805X23326"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Trop Paediatr"
                        "fecha" => "2005"
                        "volumen" => "25"
                        "paginaInicial" => "29"
                        "paginaFinal" => "34"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15814046"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Urine culture from bag specimens in young children&#58; are the risks too high&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "F&#46; Al-Orifi"
                            1 => "D&#46; McGillivray"
                            2 => "S&#46; Tange"
                            3 => "M&#46;S&#46; Kramer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1067/mpd.2000.107466"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "2000"
                        "volumen" => "137"
                        "paginaInicial" => "221"
                        "paginaFinal" => "226"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10931415"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Infecci&#243;n urinaria en el lactante&#58; comprobaci&#243;n por punci&#243;n suprap&#250;bica del rendimiento del cultivo de orina obtenido por bolsa perineal"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Benito Fern&#225;ndez"
                            1 => "J&#46; Sanchez Echeniz"
                            2 => "S&#46; Mintegui Raso"
                            3 => "M&#46; Montejo Fernandez"
                            4 => "A&#46; Calabia De Diego"
                            5 => "J&#46;A&#46; Portillo Martin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "An Esp Pediatr"
                        "fecha" => "1996"
                        "volumen" => "45"
                        "paginaInicial" => "149"
                        "paginaFinal" => "152"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8967643"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Screening for bacteriuria in newborns&#58; experience with plastic bags"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46;G&#46; Biasini"
                            1 => "C&#46; Vullo"
                            2 => "M&#46; Petrone"
                            3 => "E&#46; Pistocchi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Helv Paediatr Acta"
                        "fecha" => "1974"
                        "volumen" => "29"
                        "paginaInicial" => "575"
                        "paginaFinal" => "581"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4457515"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnosis of urinary tract infection in childhood based on examination of pared non-catheter and catheter specimens of urine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Braude"
                            1 => "J&#46;O&#46; Forfar"
                            2 => "J&#46;C&#46; Gould"
                            3 => "J&#46;W&#46; McLeod"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br Med J"
                        "fecha" => "1967"
                        "volumen" => "4"
                        "paginaInicial" => "702"
                        "paginaFinal" => "705"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4591001"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A study of some of the methods of urinary collection in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "N&#46;K&#46; Conn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Pathol"
                        "fecha" => "1970"
                        "volumen" => "23"
                        "paginaInicial" => "81"
                        "paginaFinal" => "84"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5439094"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Moving from bag to catheter for urine collection in non-toilet-trained children suspected of having urinary tract infection&#58; a paired comparison of urine cultures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Etoubleau"
                            1 => "M&#46; Reveret"
                            2 => "D&#46; Brouet"
                            3 => "I&#46; Badier"
                            4 => "P&#46; Brosset"
                            5 => "L&#46; Fourcade"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jpeds.2009.01.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "2009"
                        "volumen" => "154"
                        "paginaInicial" => "803"
                        "paginaFinal" => "806"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19375715"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Are Newcastle urine collection pads suitable as a means of collecting specimens from infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Feasey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Paediatr Nurs"
                        "fecha" => "1999"
                        "volumen" => "11"
                        "paginaInicial" => "17"
                        "paginaFinal" => "21"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10723377"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "In-out catheterization of young children with suspected urinary tract infection&#58; a retrospective journal study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46;M&#46; Gilljam"
                            1 => "M&#46;L&#46; Svensson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Paediatr Nurs"
                        "fecha" => "2008"
                        "volumen" => "34"
                        "paginaInicial" => "241"
                        "paginaFinal" => "245"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "False-positive urine cultures using bag collection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46; Grisaru-Soen"
                            1 => "R&#46; Goldman"
                            2 => "A&#46; Barzilai"
                            3 => "D&#46; Lotan"
                            4 => "N&#46; Keller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Pediatr &#40;Phila&#41;"
                        "fecha" => "2000"
                        "volumen" => "39"
                        "paginaInicial" => "499"
                        "paginaFinal" => "500"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of sterile bag&#44; clean catch and suprapubic aspiration in the diagnosis of urinary infection in early childhood"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;D&#46; Hardy"
                            1 => "P&#46;M&#46; Furnell"
                            2 => "W&#46; Brumfitt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Urol"
                        "fecha" => "1976"
                        "volumen" => "48"
                        "paginaInicial" => "279"
                        "paginaFinal" => "283"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/963408"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of urine collection methods for the diagnosis of urinary tract infection in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Karacan"
                            1 => "N&#46; Erkek"
                            2 => "S&#46; Senel"
                            3 => "S&#46; Akin Gunduz"
                            4 => "G&#46; Catli"
                            5 => "B&#46; Tavil"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000273068"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Princ Pract"
                        "fecha" => "2010"
                        "volumen" => "19"
                        "paginaInicial" => "188"
                        "paginaFinal" => "191"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20357500"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bladder aspiration for diagnosis of urinary tract infection in infants and young children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Y&#46;Y&#46; Leong"
                            1 => "K&#46;W&#46; Tan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Singap Paediatr Soc"
                        "fecha" => "1976"
                        "volumen" => "18"
                        "paginaInicial" => "43"
                        "paginaFinal" => "47"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is bag urine culture useful in monitoring urinary tract infection in infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46;S&#46; Li"
                            1 => "L&#46;C&#46; Ma"
                            2 => "S&#46;N&#46; Wong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Paediatr Child Health"
                        "fecha" => "2002"
                        "volumen" => "38"
                        "paginaInicial" => "377"
                        "paginaFinal" => "381"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12174000"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy of chlorhexidine cleansing in reducing contamination of bagged urine specimens"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "N&#46;E&#46; MacDonald"
                            1 => "S&#46; Collison"
                            2 => "N&#46; Wolfish"
                            3 => "P&#46;N&#46; McLaine"
                            4 => "A&#46;M&#46; Mackenzie"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "CMAJ"
                        "fecha" => "1985"
                        "volumen" => "133"
                        "paginaInicial" => "1211"
                        "paginaFinal" => "1213"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3933810"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pad urine collection for early childhood urinary-tract infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46;I&#46; Macfarlane"
                            1 => "C&#46; Houghton"
                            2 => "C&#46; Hughes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(99)02728-2"
                      "Revista" => array:5 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1999"
                        "volumen" => "354"
                        "paginaInicial" => "571"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10470711"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bolsa perineal versus sondaje uretral o punci&#243;n suprap&#250;bica para el diagn&#243;stico de infecci&#243;n urinaria en el lactante en las unidades de urgencias"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;J&#46; Mart&#237;n Puerto"
                            1 => "M&#46;E&#46; Cela de Juli&#225;n"
                            2 => "A&#46; Mendoza Soto"
                            3 => "J&#46; S&#225;nchez del Pozo"
                            4 => "J&#46;T&#46; Ramos Amador"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "An Esp Pediatr"
                        "fecha" => "1999"
                        "volumen" => "50"
                        "paginaInicial" => "447"
                        "paginaFinal" => "450"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10394180"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Catch or bag your specimen"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "I&#46; McKune"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Nurs Times"
                        "fecha" => "1989"
                        "volumen" => "85"
                        "paginaInicial" => "80"
                        "paginaFinal" => "82"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2813123"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidencia de infecci&#243;n urinaria en lactantes hospitalizados seg&#250;n m&#233;todo de recolecci&#243;n de la muestra para examen simple de orina"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; M&#233;ndez"
                            1 => "M&#46; Orellana"
                            2 => "F&#46; Simoes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Arch Venez Pueric Pediatr"
                        "fecha" => "2003"
                        "volumen" => "66"
                        "paginaInicial" => "2"
                        "paginaFinal" => "17"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Choice of urine collection methods for the diagnosis of urinary tract infection in young&#44; febrile infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;R&#46; Schroeder"
                            1 => "T&#46;B&#46; Newman"
                            2 => "R&#46;C&#46; Wasserman"
                            3 => "S&#46;A&#46; Finch"
                            4 => "R&#46;H&#46; Pantell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archpedi.159.10.915"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Pediatr Adolesc Med"
                        "fecha" => "2005"
                        "volumen" => "159"
                        "paginaInicial" => "915"
                        "paginaFinal" => "922"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16203935"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contamination rates of different urine collection methods for the diagnosis of urinary tract infections in young children&#58; an observational cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46; Tosif"
                            1 => "A&#46; Baker"
                            2 => "E&#46; Oakley"
                            3 => "S&#46; Donath"
                            4 => "F&#46;E&#46; Babl"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1440-1754.2012.02449.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Paediatr Child Health"
                        "fecha" => "2012"
                        "volumen" => "48"
                        "paginaInicial" => "659"
                        "paginaFinal" => "664"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22537082"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A head-to-head comparison&#58; clean-void bag versus catheter urinalysis in the diagnosis of urinary tract infection in young children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; McGillivray"
                            1 => "E&#46; Mok"
                            2 => "E&#46; Mulrooney"
                            3 => "M&#46;S&#46; Kramer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jpeds.2005.05.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "2005"
                        "volumen" => "147"
                        "paginaInicial" => "451"
                        "paginaFinal" => "456"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16227029"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nosocomial rotavirus infections&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Bruijning-Verhagen"
                            1 => "C&#46; Quach"
                            2 => "M&#46; Bonten"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2011-2779"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2012"
                        "volumen" => "129"
                        "paginaInicial" => "e1011"
                        "paginaFinal" => "e1019"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22392170"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "MRSA nasal colonization in children&#58; prevalence meta-analysis&#44; review of risk factors and molecular genetics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Gesualdo"
                            1 => "D&#46; Bongiorno"
                            2 => "C&#46; Rizzo"
                            3 => "A&#46; Bella"
                            4 => "D&#46; Menichella"
                            5 => "S&#46; Stefani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/INF.0b013e3182864e4c"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Infect Dis J"
                        "fecha" => "2013"
                        "volumen" => "32"
                        "paginaInicial" => "479"
                        "paginaFinal" => "485"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23340553"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of fetal alcohol spectrum disorders in child care settings&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Lange"
                            1 => "K&#46; Shield"
                            2 => "J&#46; Rehm"
                            3 => "S&#46; Popova"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2013-0066"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2013"
                        "volumen" => "132"
                        "paginaInicial" => "e980"
                        "paginaFinal" => "e995"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24019412"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of anxiety and depressive symptoms in adolescents with asthma&#58; a meta-analysis and meta-regression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Y&#46; Lu"
                            1 => "K-K&#46; Mak"
                            2 => "H&#46;P&#46;S&#46; van Bever"
                            3 => "T&#46;P&#46; Ng"
                            4 => "A&#46; Mak"
                            5 => "R&#46;C-M&#46; Ho"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/pai.12000"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Allergy Immunol"
                        "fecha" => "2012"
                        "volumen" => "23"
                        "paginaInicial" => "707"
                        "paginaFinal" => "715"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22957535"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Parental underestimates of child weight&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Lundahl"
                            1 => "K&#46;M&#46; Kidwell"
                            2 => "T&#46;D&#46; Nelson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2013-2690"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2014"
                        "volumen" => "133"
                        "paginaInicial" => "e689"
                        "paginaFinal" => "e703"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24488736"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Electrocardiogram screening for disorders that cause sudden cardiac death in asymptomatic children&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;M&#46; Rodday"
                            1 => "J&#46;K&#46; Triedman"
                            2 => "M&#46;E&#46; Alexander"
                            3 => "J&#46;T&#46; Cohen"
                            4 => "S&#46; Ip"
                            5 => "J&#46;W&#46; Newburger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2011-0643"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2012"
                        "volumen" => "129"
                        "paginaInicial" => "e999"
                        "paginaFinal" => "e1010"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22392183"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence and prevalence of eosinophilic esophagitis in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "I&#46;S&#46; Soon"
                            1 => "J&#46;D&#46; Butzner"
                            2 => "G&#46;G&#46; Kaplan"
                            3 => "J&#46;C&#46;C&#46; deBruyn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MPG.0b013e318291fee2"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Gastroenterol Nutr"
                        "fecha" => "2013"
                        "volumen" => "57"
                        "paginaInicial" => "72"
                        "paginaFinal" => "80"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23539047"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23412879/0000008400000002/v1_201601300058/S2341287915002100/v1_201601300058/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "26005"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008400000002/v1_201601300058/S2341287915002100/v1_201601300058/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287915002100?idApp=UINPBA00005H"
]

Article information

ISSN: 23412879
Original language: English

DOI:10.1016/j.anpede.2015.10.011

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	7	11	18
2024 October	69	42	111
2024 September	95	41	136
2024 August	97	66	163
2024 July	95	32	127
2024 June	93	42	135
2024 May	101	42	143
2024 April	92	35	127
2024 March	72	22	94
2024 February	69	23	92
2024 January	73	19	92
2023 December	80	32	112
2023 November	77	36	113
2023 October	65	26	91
2023 September	80	23	103
2023 August	89	20	109
2023 July	72	23	95
2023 June	60	31	91
2023 May	57	28	85
2023 April	55	21	76
2023 March	55	24	79
2023 February	37	18	55
2023 January	36	22	58
2022 December	56	38	94
2022 November	50	29	79
2022 October	72	76	148
2022 September	54	26	80
2022 August	59	53	112
2022 July	41	30	71
2022 June	60	36	96
2022 May	61	39	100
2022 April	58	48	106
2022 March	118	51	169
2022 February	74	51	125
2022 January	79	41	120
2021 December	60	44	104
2021 November	58	44	102
2021 October	63	64	127
2021 September	68	47	115
2021 August	52	41	93
2021 July	39	31	70
2021 June	53	44	97
2021 May	50	35	85
2021 April	157	62	219
2021 March	102	44	146
2021 February	64	16	80
2021 January	84	37	121
2020 December	61	19	80
2020 November	54	26	80
2020 October	86	16	102
2020 September	93	28	121
2020 August	121	19	140
2020 July	114	27	141
2020 June	142	26	168
2020 May	122	39	161
2020 April	38	20	58
2020 March	41	27	68
2020 February	66	23	89
2020 January	43	19	62
2019 December	75	23	98
2019 November	66	27	93
2019 October	125	27	152
2019 September	73	23	96
2019 August	72	19	91
2019 July	64	21	85
2019 June	56	36	92
2019 May	101	53	154
2019 April	112	35	147
2019 March	65	17	82
2019 February	63	24	87
2019 January	57	30	87
2018 December	71	35	106
2018 November	117	32	149
2018 October	171	43	214
2018 September	74	30	104
2018 August	1	0	1
2018 July	1	0	1
2018 June	3	0	3
2018 May	3	0	3
2018 April	23	0	23
2018 March	27	0	27
2018 February	17	0	17
2018 January	16	0	16
2017 December	11	0	11
2017 November	14	0	14
2017 October	22	0	22
2017 September	15	0	15
2017 August	13	0	13
2017 July	21	0	21
2017 June	33	23	56
2017 May	28	18	46
2017 April	14	9	23
2017 March	20	9	29
2017 February	25	2	27
2017 January	6	10	16
2016 December	30	11	41
2016 November	31	7	38
2016 October	33	6	39
2016 September	42	7	49
2016 August	35	9	44
2016 July	20	2	22

Show all

Indexed in:

Follow us:

Subscribe:

Statistics

Indexed in:

Follow us:

Subscribe:

Statistics

Subscribe to our newsletter