Suprapubic aspiration in children Pyuria is a poor predictor of infection

BMJ 1994;308:1042 (16 April)

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Suprapubic aspiration in children Pyuria is a poor predictor of infection

EDITOR, - Heloise Buys and colleagues have shown that suprapubicaspiration of urine in neonates and young children is a safeprocedure and yields good quality specimens.¹ Their study confirmsthe value of bacteriuria as a predictor of urinary tract abnormalityin this age group. Analysis of their data also supports ourview that pyuria is a poor predictor of urinary tract infection.Thus of 545 specimens examined, 439 were sterile and containedno pus cells and 60 were sterile but contained pus cells; ofthe 46 that were positive on culture, 24 contained pus cells.The sensitivity of pyuria for detecting bacteriuria is 52% (24/46);the specificity is 88% (439/499). Only 24 of 84 pyuric sampleswere bacteriuric. The positive predictive value of pyuria forbacteriuria in this study is therefore 29% (24/84), indicatingthat in this population pyuria is a poor predictor of infection.The absence of pyuria . . . [Full text of this article]

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