{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T05:55:07Z","timestamp":1781762107534,"version":"3.54.5"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":167,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Diagnosis of urinary tract infection (UTI) in children with neurogenic bladder is challenging due to frequent bacterial colonization and unreliable symptom assessment. This study aimed to evaluate the diagnostic performance of urinalysis parameters in predicting urine culture positivity in children undergoing clean intermittent catheterization (CIC).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We retrospectively analyzed urine samples from children with neurogenic bladder who underwent CIC between 2015 and 2024. All samples were included regardless of symptom status. Urinalysis parameters, including leukocyte esterase (LE), nitrite, pyuria, and bacteriuria, were evaluated. Culture positivity was defined as growth of a single organism \u2265\u200910\n 5<\/jats:sup>\n \u2009CFU\/mL. Generalized estimating equations were used to account for repeated measurements. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios were calculated for individual and combined parameters.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 1362 urine samples from 107 patients were analyzed. The combination \u201cNitrite OR Bacteriuria\u201d achieved the highest AUC (0.84), with sensitivity 0.85, specificity 0.84, PPV 0.84, NPV 0.85, and NLR 0.18. The three\u2010parameter combination \u201cLE OR Nitrite OR Bacteriuria\u201d showed the highest sensitivity (0.94) and NPV (0.92), with an NLR of 0.10 indicating strong rule\u2010out potential. Among AND\u2010rule combinations, \u201cLE AND Nitrite\u201d showed the highest specificity (0.98) and PPV (0.93; PLR 14.27), but low sensitivity (0.36).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Urinalysis parameter combinations may help predict urine culture positivity (\u2265\u200910\n 5<\/jats:sup>\n \u2009CFU\/mL) in children undergoing CIC, though these findings cannot distinguish between asymptomatic bacteriuria and clinically significant UTI requiring treatment.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ped.70452","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T05:26:47Z","timestamp":1781760407000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Urinalysis Abnormalities and Culture Positivity in Children With Clean Intermittent Catheterization"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6951-3494","authenticated-orcid":false,"given":"Nilsun","family":"Kuas","sequence":"first","affiliation":[{"name":"Department of Pediatric Urology Eski\u015fehir City Hospital Eski\u015fehir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8212-5776","authenticated-orcid":false,"given":"Aylin","family":"Gen\u00e7ler","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology Eski\u015fehir City Hospital Eski\u015fehir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.24211"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.25245"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2025.09.008"},{"key":"e_1_2_10_5_1","first-page":"808","article-title":"Pyuria as a Marker of Urinary Tract Infection in Neurogenic Bladder: Is It Reliable?","volume":"202","author":"Guerra L. A.","year":"2019","journal-title":"J Urol"},{"issue":"5","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"488.e1","DOI":"10.1016\/j.jpurol.2017.01.016","article-title":"Utility of a Routine Urinalysis in Children Who Require Clean Intermittent Catheterization","volume":"13","author":"Forster C. S.","year":"2017","journal-title":"J Pediatr Urol"},{"issue":"6","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.jpurol.2018.07.016","article-title":"Variation Among Subspecialists in the Diagnosis of Urinary Tract Infection in Children With Neurogenic Bladders","volume":"14","author":"Forster C. S.","year":"2018","journal-title":"J Pediatr Urol"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2018.03.017"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.jpeds.2018.07.007","article-title":"Microscopic Bacteriuria Detected by Automated Urinalysis for the Diagnosis of Urinary Tract Infection","volume":"202","author":"Chaudhari P. P.","year":"2018","journal-title":"J Pediatr"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2025.10.019"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.5489\/cuaj.8390"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy1121"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41393\u2010021\u201000679\u20105"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2023.09.023"}],"container-title":["Pediatrics International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70452","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ped.70452","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70452","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T05:26:48Z","timestamp":1781760408000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ped.70452"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/ped.70452"],"URL":"https:\/\/doi.org\/10.1111\/ped.70452","archive":["Portico"],"relation":{},"ISSN":["1328-8067","1442-200X"],"issn-type":[{"value":"1328-8067","type":"print"},{"value":"1442-200X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-04-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70452"}}