Biomaterial Database

Variation among subspecialists in the diagnosis of urinary tract infection in children with neurogenic bladders. 2018

C S Forster, and E Jackson, and S L Goldstein

Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA. Electronic address: csforster@childrensnational.org.

Children with neurogenic bladders who require clean intermittent catheterization (CIC) frequently have bacteriuria. However, there is no consensus on what constitutes at urinary tract infection (UTI) in this population. Multiple subspecialists are often involved in the management of these patients, although they are frequently cared for by hospitalists when admission is required. The objective of this study was to describe the variability in opinion between subspecialists in the diagnosis of a UTI in CIC-dependent children. A scenario-based survey was distributed to physicians in the divisions of urology, nephrology, and hospital medicine at a single free-standing children's hospital. Respondents rated their degree of confidence on whether a specific scenario represented UTI or colonization on an 11-point Likert Scale. Median responses were compared with the Kruskal-Wallis test with pair-wise comparisons. Back/flank pain, abdominal pain, and vomiting were the most common symptoms that were suggestive of a UTI in a non-febrile child. There was no single symptom chosen that was the most suggestive of a UTI in CIC-dependent child. There was significant variability between specialists in the diagnosis of UTI in specific clinical scenarios on the survey. Hospitalists were significantly less confident about the diagnosis of a UTI than urologists in two of the clinical scenarios. Standardization and implementation of consensus criteria for UTI in this high-risk population is needed.

UI	MeSH Term	Description	Entries
D008511	Medicine	The art and science of studying, performing research on, preventing, diagnosing, and treating disease, as well as the maintenance of health.	Insurance Medicine,Medical Specialities,Medical Specialties,Medical Specialty,Specialities, Medical,Specialties, Medical,Specialty, Medical,Insurance Medicines,Medical Speciality,Medicine, Insurance,Medicines, Insurance,Speciality, Medical
D009398	Nephrology	A subspecialty of internal medicine concerned with the anatomy, physiology, and pathology of the kidney.
D010818	Practice Patterns, Physicians'	Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.	Clinical Practice Patterns,Physician's Practice Patterns,Clinical Practice Pattern,Pattern, Clinical Practice,Patterns, Clinical Practice,Practice Pattern, Clinical,Practice Patterns, Clinical,Practice Patterns, Physician's,Prescribing Patterns, Physician,Physician Practice Patterns,Physician Prescribing Pattern,Physician Prescribing Patterns,Physician's Practice Pattern,Physicians' Practice Pattern,Physicians' Practice Patterns,Practice Pattern, Physician's,Practice Pattern, Physicians',Practice Patterns, Physician,Prescribing Pattern, Physician
D001750	Urinary Bladder, Neurogenic	Dysfunction of the URINARY BLADDER due to disease of the central or peripheral nervous system pathways involved in the control of URINATION. This is often associated with SPINAL CORD DISEASES, but may also be caused by BRAIN DISEASES or PERIPHERAL NERVE DISEASES.	Bladder Disorder, Neurogenic,Neurogenic Bladder,Bladder Neurogenesis,Bladder, Neurogenic,Neurogenic Bladder Disorder,Neurogenic Bladder, Atonic,Neurogenic Bladder, Spastic,Neurogenic Bladder, Uninhibited,Neurogenic Dysfunction of the Urinary Bladder,Neurogenic Urinary Bladder Disorder,Neurogenic Urinary Bladder, Atonic,Neurogenic Urinary Bladder, Spastic,Neurogenic Urinary Bladder, Uninhibited,Neuropathic Bladder,Urinary Bladder Disorder, Neurogenic,Urinary Bladder Neurogenesis,Urinary Bladder Neurogenic Dysfunction,Atonic Neurogenic Bladder,Neurogenesis, Bladder,Neurogenesis, Urinary Bladder,Neurogenic Bladder Disorders,Neurogenic Urinary Bladder,Spastic Neurogenic Bladder,Uninhibited Neurogenic Bladder
D002648	Child	A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL.	Children
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014552	Urinary Tract Infections	Inflammatory responses of the epithelium of the URINARY TRACT to microbial invasions. They are often bacterial infections with associated BACTERIURIA and PYURIA.	Infection, Urinary Tract,Infections, Urinary Tract,Tract Infection, Urinary,Tract Infections, Urinary,Urinary Tract Infection
D014572	Urology	A surgical specialty concerned with the study, diagnosis, and treatment of diseases of the urinary tract in both sexes, and the genital tract in the male. Common urological problems include urinary obstruction, URINARY INCONTINENCE, infections, and UROGENITAL NEOPLASMS.
D057928	Intermittent Urethral Catheterization	Insertion of a catheter into the urethra to drain the urine from the bladder at intervals as needed.	Clean Intermittent Catheterization,Urethral Self-Catheterization,Catheterization, Intermittent Urethral,Catheterizations, Intermittent Urethral,Intermittent Urethral Catheterizations,Self-Catheterization, Urethral,Self-Catheterizations, Urethral,Urethral Catheterization, Intermittent,Urethral Catheterizations, Intermittent,Urethral Self Catheterization,Urethral Self-Catheterizations
D019538	Health Care Surveys	Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.	Healthcare Surveys,National Ambulatory Medical Care Survey,National Hospital Discharge Survey,Care Survey, Health,Care Surveys, Health,Health Care Survey,Healthcare Survey,Survey, Health Care,Survey, Healthcare,Surveys, Health Care,Surveys, Healthcare