Skip to main content
NCBI home page
British Medical Journal logoLink to British Medical Journal
. 1975 May 31;2(5969):463–467. doi: 10.1136/bmj.2.5969.463

Screening methods for covert bacteriuria in schoolgirls.

B Edwards, R H White, H Maxted, I Deverill, P A White
PMCID: PMC1673433  PMID: 1097030

Abstract

Screening tests for bacteriuria based on two different principles were evaluated in1582 schoolgirls aged 5-11 years, and in 26 girls aged 3-16 years attending hospitalwith symptomatic urinary tract infection. Tests for hypoglucosuria, performed by a semi-automated fluorometric method and with Uriglox strips on early-morning urine samples voided after overnight fasting, gave unacceptably high false-negative rates (16.7% and 20.8% respectively). Oxoid and Uricult dipslides were immersed in fresh midstreamspecimens of urine obtained at school and read overnight incubation at 37 degrees C.Both gave comparable results, with low false-positive rates and no false-negative responses. The higher cost of screening by dipslides was halved by using the "dipstream" technique, which also gave no false-negative results. Its false-positive rate of 13.5% could be reduced to 1.8% by disregarding colony counts of 10-8 non-faecal organisms and over per litre, which appear unimportant in schoolchildren. Bacteriuria was found in 2.3% of the schoolgirls; 39% of them had symptons, compared with 7.2% of the healthy girls, and 25% showed vesicoureteric reflux, which in 17% was associated with renalscarring. Since the natural history of covert bacteriuria and its relationship withreflux and scarring remain undetermined further research is required. The dipstreamtechnique offers a simple, reliable, and comparatively cheap screening method which could also be applied in general practice.

Full text

PDF
463

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arneil G. C., McAllister T. A., Kay P. Detection of bacteriuria at room-temperature. Lancet. 1970 Jan 17;1(7638):119–121. doi: 10.1016/s0140-6736(70)90468-x. [DOI] [PubMed] [Google Scholar]
  2. Asscher A. W., McLachlan M. S., Jones R. V., Meller S., Sussman M., Harrison S., Johnston H. H., Sleight G., Fletcher E. W. Screening for asymptomatic urinary-tract infection in schoolgirls. A two-centre feasibility study. Lancet. 1973 Jul 7;2(7819):1–4. doi: 10.1016/s0140-6736(73)91943-0. [DOI] [PubMed] [Google Scholar]
  3. Bailey R. R. The relationship of vesico-ureteric reflux to urinary tract infection and chronic pyelonephritis-reflux nephropathy. Clin Nephrol. 1973 May-Jun;1(3):132–141. [PubMed] [Google Scholar]
  4. Braude H., Forfar J. O., Gould J. C., McLeod J. W. Diagnosis of urinary tract infection in childhood based on examination of pared non-catheter and catheter specimens of urine. Br Med J. 1967 Dec 23;4(5581):702–705. doi: 10.1136/bmj.4.5581.702. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dosa S., Houston I. B., Allen L. B., Jennison R. Urinary glucose unreliable as test for urinary tract infection in infancy. Arch Dis Child. 1973 Sep;48(9):733–737. doi: 10.1136/adc.48.9.733. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Huttunen N. P., Mella E., Mäkelä P. Simple method for increasing reliability in diagnosis of urinary infection. Lancet. 1970 Jan 3;1(7636):22–22. doi: 10.1016/s0140-6736(70)90528-3. [DOI] [PubMed] [Google Scholar]
  7. KUNIN C. M., ZACHA E., PAQUIN A. J., Jr Urinary-tract infections in schoolchildren. I. Prevalence of bacteriuria and associated urologic findings. N Engl J Med. 1962 Jun 21;266:1287–1296. doi: 10.1056/NEJM196206212662501. [DOI] [PubMed] [Google Scholar]
  8. Köhler L., Fritz H., Scherstén B. Health control of four-year-old children. A study of bacteriuria. Acta Paediatr Scand. 1972 May;61(3):289–295. doi: 10.1111/j.1651-2227.1972.tb16101.x. [DOI] [PubMed] [Google Scholar]
  9. Mackinnon A. E., Strachan C. J., Sleigh J. D., Burns M. M. Screening for bacteriuria with a dip-stick test for urinary glucose. Br J Urol. 1974 Feb;46(1):101–105. doi: 10.1111/j.1464-410x.1974.tb10167.x. [DOI] [PubMed] [Google Scholar]
  10. McAllister T. A., Arneil G. C., Barr W., Kay P. Assessment of plane dipslide quantitation of bacteriuria. Nephron. 1973;11(2):111–122. doi: 10.1159/000180224. [DOI] [PubMed] [Google Scholar]
  11. McKusick V. A., Weilbaecher R. G., Gragg G. W. Recessive inheritance of a congenital malformation syndrome: unilateral absence deformity of leg and congenital cataracts. JAMA. 1968 Apr 8;204(2):113–118. [PubMed] [Google Scholar]
  12. Parsons V., Patel H. R., Stodell A., Armstrong P., Epsom J. E., Thrower A. L. Symptoms by questionaire and signs by dipstream culture of urinary tract infection in schoolgirls of south-east London. Clin Nephrol. 1974 Sep-Oct;2(5):179–185. [PubMed] [Google Scholar]
  13. Rolleston G. L., Maling T. M., Hodson C. J. Intrarenal reflux and the scarred kidney. Arch Dis Child. 1974 Jul;49(7):531–539. doi: 10.1136/adc.49.7.531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Rolleston G. L., Shannon F. T., Utley W. L. Relationship of infantile vesicoureteric reflux to renal damage. Br Med J. 1970 Feb 21;1(5694):460–463. doi: 10.1136/bmj.1.5694.460. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Savage D. C., Wilson M. I., McHardy M., Dewar D. A., Fee W. M. Covert bacteriuria of childhood. A clinical and epidemiological study. Arch Dis Child. 1973 Jan;48(1):8–20. doi: 10.1136/adc.48.1.8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Scherstén B., Tibbling G. Semiautomated assay of normal concentrations of urinary glucose by an enzymatic fluorometric technic. Clin Chem. 1968 Mar;14(3):243–252. [PubMed] [Google Scholar]
  17. Walten M. G., Jr, Kunin C. M. Significance of borderline counts in screening programs for bacteriuria. J Pediatr. 1971 Feb;78(2):246–249. doi: 10.1016/s0022-3476(71)80007-0. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES