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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Comparar la tinci&#243;n de Gram y la tira reactiva en orina&#44; como m&#233;todos para el diagn&#243;stico de la infecci&#243;n del tracto urinario &#40;ITU&#41;&#44; en el lactante con fiebre</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo de 175 lactantes con fiebre&#44; con edades comprendidas entre 1 y 24 meses&#44; en los que se analiz&#243; la orina para descartar la presencia de ITU&#46; Adem&#225;s del an&#225;lisis de orina mediante tira reactiva para detectar la presencia de leucocitos y nitritos&#44; se envi&#243; una muestra para tinci&#243;n de Gram y urocultivo&#46; La orina se recogi&#243; mediante sondaje uretral&#46; Se consider&#243; urocultivo positivo al crecimiento de m&#225;s de 50&#46;000 col&#46;&#47;ml del mismo germen</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La edad media de los pacientes fue de 9&#44;8 meses&#46; El uro-cultivo result&#243; positivo en 87 pacientes &#40;49&#44;5 &#37;&#41;&#46; El diagn&#243;stico de ITU se estableci&#243; en 91 pacientes &#40;51&#44;9&#37;&#41; siendo hospitalizados 74 de ellos con sospecha cl&#237;nica de pielonefritis &#40;81&#44;3&#37;&#41;&#46; La prueba m&#225;s sensible fue la leuco-cituria &#40;90&#44;8&#37;&#41; y la m&#225;s espec&#237;fica la tinci&#243;n de Gram &#40;98&#44;9 &#37;&#41;&#46; Destac&#243; como prueba de mayor rendimiento global la suma de aplicar como m&#233;todo diagn&#243;stico la leuco-cituria m&#225;s la tinci&#243;n de Gram&#58; sensibilidad&#44; 93&#44;1 &#37;&#59; especificidad&#44; 98&#44;4&#37;&#59; valor predictivo positivo &#40;VPP&#41;&#44; 98&#44;5&#37;&#44; y valor predictivo negativo &#40;VPN&#41;&#44; 92&#44;5 &#37;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La tinci&#243;n de Gram en orina es un m&#233;todo diagn&#243;stico de mayor rendimiento que la tira reactiva para detectar ITU en el lactante febril pero debe interpretarse conjuntamente con los resultados de esta &#250;ltima</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetive</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To compare urinary Gram staining and dipstick for the detection of urinary tract infection &#40;UTI&#41; in febrile infants</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Prospective study of 175 febrile infants aged 1-24 months&#46; In all infants&#44; a urine specimen was analyzed to detect UTI&#46; The dipstick test was used to detect leukocytes and nitrites and samples were taken for Gram staining and urine culture&#46; Urine was obtained by urethral catheterization&#46; Positive urine results were defined as &#62; 50&#46;000 colony-forming units per millimeter of urinary tract pathogen</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The mean age was 9&#46;8 months &#40;SD&#58; 6&#46;64&#41;&#46; Urine culture was positive in 87 patients &#40;49&#46;5 &#37;&#41;&#46; Diagnosis of UTI was confirmed in 91 patients &#40;51&#46;9 &#37;&#41;&#44; of whom 74 were admitted for clinically suspected pyelonephritis &#40;81&#46;3&#37;&#41;&#46; Gram stain had the highest specificity &#40;98&#46;9&#37;&#41; and pyuria the highest sensitivity &#40;90&#46;8&#37;&#41;&#46; Better results were obtained using the combination of dipstick and Gram stain with a sensitivity of 93&#46;1&#37;&#44; specificity of 98&#46;4&#37;&#44; positive predictive value of 98&#46;5 &#37; and negative predictive value of 92&#46;5&#37;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Urinary Gram stain appears to be more reliable than dipstick in detecting UTI in febrile infants but the results of both tests should be interpreted together</p>"
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Vol. 53. Núm. 6.
Páginas 561-566 (diciembre 2000)
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Vol. 53. Núm. 6.
Páginas 561-566 (diciembre 2000)
Acceso a texto completo
Tinción de Gram y tira reactiva como métodos diagnósticos de la infección del tracto urinario del lactante con fiebre
Urinary gram stain and dipstick for detection of urinary tract infection in febrile infants
Visitas
15723
J. Benito Fernándeza,
Autor para correspondencia
jbenito@hcru.osakidetza.net

Correspondencia: Sección de Urgencias de Pediatría. Hospital de Cruces. Pl. de Cruces, s/n. 48903 Baracaldo. Bilbao
, A. García Ribesa, N. Trebolazabala Quirantea, S. Mintegi Rasoa, M.A. Vázquez Roncoa, E. Urra Zalbidegoitiab
a Sección de Urgencias de Pediatría, Departamento de Pediatría. Hospital de Cruces. Bilbao
b Servicio de Microbiología. Hospital de Cruces. Bilbao
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Bibliografía
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Estadísticas
Objetivo

Comparar la tinción de Gram y la tira reactiva en orina, como métodos para el diagnóstico de la infección del tracto urinario (ITU), en el lactante con fiebre

Pacientes y métodos

Estudio prospectivo de 175 lactantes con fiebre, con edades comprendidas entre 1 y 24 meses, en los que se analizó la orina para descartar la presencia de ITU. Además del análisis de orina mediante tira reactiva para detectar la presencia de leucocitos y nitritos, se envió una muestra para tinción de Gram y urocultivo. La orina se recogió mediante sondaje uretral. Se consideró urocultivo positivo al crecimiento de más de 50.000 col./ml del mismo germen

Resultados

La edad media de los pacientes fue de 9,8 meses. El uro-cultivo resultó positivo en 87 pacientes (49,5 %). El diagnóstico de ITU se estableció en 91 pacientes (51,9%) siendo hospitalizados 74 de ellos con sospecha clínica de pielonefritis (81,3%). La prueba más sensible fue la leuco-cituria (90,8%) y la más específica la tinción de Gram (98,9 %). Destacó como prueba de mayor rendimiento global la suma de aplicar como método diagnóstico la leuco-cituria más la tinción de Gram: sensibilidad, 93,1 %; especificidad, 98,4%; valor predictivo positivo (VPP), 98,5%, y valor predictivo negativo (VPN), 92,5 %

Conclusión

La tinción de Gram en orina es un método diagnóstico de mayor rendimiento que la tira reactiva para detectar ITU en el lactante febril pero debe interpretarse conjuntamente con los resultados de esta última

Palabras clave:
Tinción de Gram
Tira reactiva
Infección del tracto urinario
Lactante febril
Objetive

To compare urinary Gram staining and dipstick for the detection of urinary tract infection (UTI) in febrile infants

Methods

Prospective study of 175 febrile infants aged 1-24 months. In all infants, a urine specimen was analyzed to detect UTI. The dipstick test was used to detect leukocytes and nitrites and samples were taken for Gram staining and urine culture. Urine was obtained by urethral catheterization. Positive urine results were defined as > 50.000 colony-forming units per millimeter of urinary tract pathogen

Results

The mean age was 9.8 months (SD: 6.64). Urine culture was positive in 87 patients (49.5 %). Diagnosis of UTI was confirmed in 91 patients (51.9 %), of whom 74 were admitted for clinically suspected pyelonephritis (81.3%). Gram stain had the highest specificity (98.9%) and pyuria the highest sensitivity (90.8%). Better results were obtained using the combination of dipstick and Gram stain with a sensitivity of 93.1%, specificity of 98.4%, positive predictive value of 98.5 % and negative predictive value of 92.5%

Conclusion

Urinary Gram stain appears to be more reliable than dipstick in detecting UTI in febrile infants but the results of both tests should be interpreted together

Key words:
Gram stain
Dipstick
Urinary tract infection
Febrile infant
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Bibliografía
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Copyright © 2000. Asociación Española de Pediatría
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