AimsTo identify:1. The most common presenting complaints of infants that have urine samples sent for microscopy and culture2. If dipstick analysis is a reliable investigation in diagnosing urinary tract infection in infants under the age of 13. If urine microscopy is a reliable investigation in diagnosing urinary tract infection in infants under the age of 1MethodRetrospective case note review of all patients under the age of 1 with urine samples sent for culture from Children’s ward in RAH between January and March 2016.Results98 samples included in study.84 patients (49 male, 35 female).26 infants (31%) had full septic screen and commenced on IV antibiotics as per local guidelines.94 samples obtained by clean catch urine, 1 sample from in- and-out catheter and 1 suprapubic aspiration.48% of patients presented with pyrexia and 18% with vomiting.33 patients had no documented urinalysis, 5 samples were positive.12 samples were positive for leucocytes +/ nitrites, 33% had a positive culture.ConclusionsMost common presenting complaint in infants that have a urine sample sent is temperature.Difficult to compare data due to differences in numbers of negative and positive results.Dipstick analysis is not a sensitive measure of infection in this age group.The majority of negative cultures will have either ‘scanty or nil’ organisms on microscopy.58% of positive cultures have ‘scanty’ cell counts likely to get false negatives.A sample with numerous cells and numerous organisms is likely to be a positive UTI.The majority (76%) of negative cultures have scanty or nil on cell count.RecommendationsBetter documentation of urinalysis results on the ward.Further data needs to be analysed as small sample included in this study.Further audit after feedback to ward staff to identify improvement in urinalysis documentation.
AimsTo identify:Clinical indications for performing coagulation screens.Abnormalities found in coagulation screens.Management and follow up of abnormal coagulation screens.MethodA retrospective case note review of patients aged 0–16 years who had a coagulation screen during a 6 month period from 1 st January until 30th June 2017.Results219 samples were analysed. 45% (n=99) were male and 55% (n=120) female, aged 4 days to 16 years. The most common indication for performing a coagulation screen was presence of a non-blanching rash 32% (n=71). Bloody diarrhoea 7% (n=19), paracetamol overdose 7% (n=15) and child protection medicals 5% (n=12) were the next most common indications.66.7% (n=146) of samples had at least one abnormality. 29% (n=64) of prothrombin times (PT), 25% (n=55) of activated partial thromboplastin time (APTT) and 35% (n=81) thrombin times (TT) were outwith the normal values for age. 62% (n=91) had mildly abnormal results. Abnormal results were commonest in the 1 to 5 year old group 32% (n=47).In those with mildly abnormal results repeat samples were arranged in 16% (n=15), whereas in coagulation screens with greater abnormalities repeat sampling was arranged in 55% (n=30). Repeat samples were carried out at a median of 7 days from the original sample (range 0–129 days).One patient received i.v. vitamin K for prolonged PT and 3 patients were referred to haematology. Two of who had family members with a clotting disorder and one had a new diagnosis of haemophilia B.ConclusionsThe commonest reason for performing a coagulation screen was a non–blanching rash.The commonest abnormality is a prolonged TT, followed by PT then APTT.There is wide variability in follow up and timing of follow up of abnormal coagulation screens.Children with mildly abnormal screens are least likely to have repeat sampling.Recommendation1. To develop a guideline to unify the follow up of abnormal coagulation screens.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.