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Test characteristics of tests used to diagnose urinary tract infections in young infants (≤60 days)*

Test characteristics of tests used to diagnose urinary tract infections in young infants (≤60 days)*
  Sensitivity
(95% CI)		 Specificity
(95% CI)		 Positive likelihood ratio
(95% CI)		 Negative likelihood ratioΔ
(95% CI)
Leukocyte esterase (LE)◊ 92% (89-95%) 96% (95-96%) 21
(95% CIs not available)		 0.08
(95% CIs not available)
Nitrite 38% (33-44%) 99% (99-100%) 71
(95% CIs not available)		 0.6
(95% CIs not available)
LE or nitrite 93% (90-96%) 95% (95-96%) 19
(95% CIs not available)		 0.07
(95% CIs not available)
Pyuria (>5 WBC/hpf) 82% (77-86%) 94% (93-94%) 13
(95% CIs not available)		 0.2
(95% CIs not available)
LE or nitrite or pyuria 94% (91-97%) 91% (90-91%) 10.0 (9.0-11.1) 0.06 (0.04-0.1)
CI: confidence interval; LE: leukocyte esterase; WBC: white blood cell; hpf: high-power field; UTI: urinary tract infection.
* Results are based upon urine obtained by catheterization or suprapubic aspiration.
¶ The positive likelihood ratio is the probability that an infant with a UTI will have a positive test divided by the probability that an infant without a UTI will have a positive test (eg, true-positive rate/false-positive rate). The higher the positive likelihood ratio, the better the test (a positive likelihood ratio >10 indicates excellent test performance; a perfect test would have a positive likelihood ration of infinity).
Δ The negative likelihood ratio is the probability that an infant with a UTI will have a negative test divided by the probability that an infant without a UTI will have a negative test (eg, false-negative rate/true-negative rate). The lower the negative likelihood ratio, the better the test (a negative likelihood ratio <0.1 indicates excellent test performance; a perfect test has a negative likelihood ratio of 0).
◊ This includes any positive LE result, including a trace amount.
Adapted from: Tzimenatos L, Mahajan P, Dayan PS, et al. Accuracy of the Urinalysis for Urinary Tract Infections in Febrile Infants 60 Days and Younger. Pediatrics 2018.
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