Prediction of Bacterial Etiology in Pediatric Patients with Acute Epididymitis: A Comparison of C-Reactive Protein and Urinalysis in Terms of Diagnostic Accuracy
<b>Background/Objectives</b>: We aimed to determine the proportion of bacterial etiology in pediatric acute epididymitis (AE) and to compare the predictive accuracy of C-reactive protein (CRP) and urinalysis. <b>Methods</b>: Pediatric patients diagnosed with AE in National Ta...
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2024-12-01
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| author | Kang Liu Chi-Shin Tseng Shin-Mei Wong Kuo-How Huang I-Ni Chiang Chao-Yuan Huang Chih-Hung Chiang |
| author_facet | Kang Liu Chi-Shin Tseng Shin-Mei Wong Kuo-How Huang I-Ni Chiang Chao-Yuan Huang Chih-Hung Chiang |
| author_sort | Kang Liu |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: We aimed to determine the proportion of bacterial etiology in pediatric acute epididymitis (AE) and to compare the predictive accuracy of C-reactive protein (CRP) and urinalysis. <b>Methods</b>: Pediatric patients diagnosed with AE in National Taiwan University Hospital from 2009 to 2018 were retrospectively identified. Patient profiles, including clinical symptoms, physical findings, laboratory data, and treatment types, were collected. Patients were categorized into acute bacterial epididymitis (ABE) or acute non-bacterial epididymitis (ANBE) groups based on the presence or absence of bacterial growth in urine cultures. The primary endpoints were the proportion of patients with ABE and those who received antibiotic therapy. The secondary endpoint was to assess the diagnostic accuracy of CRP and urinalysis for ABE. <b>Results</b>: The final cohort comprised of 289 patients, of whom 216 (74.7%) received antibiotics. Urine culture was obtained for 167 (57.8%) patients, and 52 (31.1%) were positive for a bacterial source. The median CRP and positive rate for urinalysis were significantly higher in the ABE group compared to the ANBE group (CRP: 3.68 vs. 0.25 mg/dL; <i>p</i> < 0.001; urinalysis: 41% vs. 23%; <i>p</i> = 0.005). Multivariate analysis revealed that elevated CRP was significantly associated with AE (odds ratio [OR], 61.96; <i>p</i> < 0.001), whereas positive urinalysis was not (OR, 2.09; <i>p</i> = 0.33). The area under the receiver operating characteristic curves for CRP was higher than that for urinalysis (0.82 vs. 0.72). <b>Conclusions</b>: Serum CRP proved to be a more accurate and reliable tool than urinalysis for predicting pediatric ABE. This could provide guidance to practitioners when prescribing antibiotics in the future. |
| format | Article |
| id | doaj-art-f6d829a25e2d4085a8dcbff50787854d |
| institution | Kabale University |
| issn | 2227-9059 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj-art-f6d829a25e2d4085a8dcbff50787854d2024-12-27T14:13:06ZengMDPI AGBiomedicines2227-90592024-12-011212286610.3390/biomedicines12122866Prediction of Bacterial Etiology in Pediatric Patients with Acute Epididymitis: A Comparison of C-Reactive Protein and Urinalysis in Terms of Diagnostic AccuracyKang Liu0Chi-Shin Tseng1Shin-Mei Wong2Kuo-How Huang3I-Ni Chiang4Chao-Yuan Huang5Chih-Hung Chiang6Department of Education, National Taiwan University Hospital, National Taiwan University, Taipei 100229, TaiwanDepartment of Urology, National Taiwan University Hospital, National Taiwan University, Taipei 100229, TaiwanDepartment of Urology, National Taiwan University Hospital, National Taiwan University, Taipei 100229, TaiwanDepartment of Urology, National Taiwan University Hospital, National Taiwan University, Taipei 100229, TaiwanDepartment of Urology, National Taiwan University Hospital, National Taiwan University, Taipei 100229, TaiwanDepartment of Urology, National Taiwan University Hospital, National Taiwan University, Taipei 100229, TaiwanDepartment of Urology, National Taiwan University Hospital, National Taiwan University, Taipei 100229, Taiwan<b>Background/Objectives</b>: We aimed to determine the proportion of bacterial etiology in pediatric acute epididymitis (AE) and to compare the predictive accuracy of C-reactive protein (CRP) and urinalysis. <b>Methods</b>: Pediatric patients diagnosed with AE in National Taiwan University Hospital from 2009 to 2018 were retrospectively identified. Patient profiles, including clinical symptoms, physical findings, laboratory data, and treatment types, were collected. Patients were categorized into acute bacterial epididymitis (ABE) or acute non-bacterial epididymitis (ANBE) groups based on the presence or absence of bacterial growth in urine cultures. The primary endpoints were the proportion of patients with ABE and those who received antibiotic therapy. The secondary endpoint was to assess the diagnostic accuracy of CRP and urinalysis for ABE. <b>Results</b>: The final cohort comprised of 289 patients, of whom 216 (74.7%) received antibiotics. Urine culture was obtained for 167 (57.8%) patients, and 52 (31.1%) were positive for a bacterial source. The median CRP and positive rate for urinalysis were significantly higher in the ABE group compared to the ANBE group (CRP: 3.68 vs. 0.25 mg/dL; <i>p</i> < 0.001; urinalysis: 41% vs. 23%; <i>p</i> = 0.005). Multivariate analysis revealed that elevated CRP was significantly associated with AE (odds ratio [OR], 61.96; <i>p</i> < 0.001), whereas positive urinalysis was not (OR, 2.09; <i>p</i> = 0.33). The area under the receiver operating characteristic curves for CRP was higher than that for urinalysis (0.82 vs. 0.72). <b>Conclusions</b>: Serum CRP proved to be a more accurate and reliable tool than urinalysis for predicting pediatric ABE. This could provide guidance to practitioners when prescribing antibiotics in the future.https://www.mdpi.com/2227-9059/12/12/2866acute epididymitispediatricbacterial infectionC-reactive proteinurinalysisantibiotics |
| spellingShingle | Kang Liu Chi-Shin Tseng Shin-Mei Wong Kuo-How Huang I-Ni Chiang Chao-Yuan Huang Chih-Hung Chiang Prediction of Bacterial Etiology in Pediatric Patients with Acute Epididymitis: A Comparison of C-Reactive Protein and Urinalysis in Terms of Diagnostic Accuracy Biomedicines acute epididymitis pediatric bacterial infection C-reactive protein urinalysis antibiotics |
| title | Prediction of Bacterial Etiology in Pediatric Patients with Acute Epididymitis: A Comparison of C-Reactive Protein and Urinalysis in Terms of Diagnostic Accuracy |
| title_full | Prediction of Bacterial Etiology in Pediatric Patients with Acute Epididymitis: A Comparison of C-Reactive Protein and Urinalysis in Terms of Diagnostic Accuracy |
| title_fullStr | Prediction of Bacterial Etiology in Pediatric Patients with Acute Epididymitis: A Comparison of C-Reactive Protein and Urinalysis in Terms of Diagnostic Accuracy |
| title_full_unstemmed | Prediction of Bacterial Etiology in Pediatric Patients with Acute Epididymitis: A Comparison of C-Reactive Protein and Urinalysis in Terms of Diagnostic Accuracy |
| title_short | Prediction of Bacterial Etiology in Pediatric Patients with Acute Epididymitis: A Comparison of C-Reactive Protein and Urinalysis in Terms of Diagnostic Accuracy |
| title_sort | prediction of bacterial etiology in pediatric patients with acute epididymitis a comparison of c reactive protein and urinalysis in terms of diagnostic accuracy |
| topic | acute epididymitis pediatric bacterial infection C-reactive protein urinalysis antibiotics |
| url | https://www.mdpi.com/2227-9059/12/12/2866 |
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