Bedside Leukocyte Esterase Testing to aid in Diagnosing Bacterial Conjunctivitis in Children.

conjunctivitis etiology infectious disease leukocyte esterase test strip pediatrics

Journal

The Journal of emergency medicine

ISSN: 0736-4679

Titre abrégé: J Emerg Med

Pays: United States

ID NLM: 8412174

Informations de publication

Date de publication:
09 Nov 2023

Historique:

received: 27 02 2023

revised: 03 11 2023

accepted: 05 11 2023

medline: 4 2 2024

pubmed: 4 2 2024

entrez: 3 2 2024

Statut: aheadofprint

Résumé

Conjunctivitis is a frequent symptom in pediatric emergency departments; however, the etiology of conjunctivitis is difficult to clinically differentiate. Our study objective was to evaluate the test performance characteristics of leukocyte esterase (LE) test strips in diagnosing bacterial conjunctivitis. Patients aged from 3 months through 21 years presenting to an emergency department with symptoms of conjunctivitis were prospectively enrolled from September 2018 to March 2020. A swab of the affected eye was applied to the LE test strip and another swab was sent for culture processing. The primary outcome was the association between LE test results and eye culture results. We enrolled 189 patients. Overall, 117 eye cultures (62%) were positive. The sensitivity and specificity of LE testing was 96% (95% CI 90-98%) and 14% (95% CI 7-25%), respectively. Positive predictive value was 64% (95% CI 57-71%) and negative predictive value was 67% (95% CI 39-87%). The LE test strip had limited ability to differentiate bacterial conjunctivitis from other etiologies.

Sections du résumé

BACKGROUND BACKGROUND

Conjunctivitis is a frequent symptom in pediatric emergency departments; however, the etiology of conjunctivitis is difficult to clinically differentiate.

OBJECTIVE OBJECTIVE

Our study objective was to evaluate the test performance characteristics of leukocyte esterase (LE) test strips in diagnosing bacterial conjunctivitis.

METHODS METHODS

Patients aged from 3 months through 21 years presenting to an emergency department with symptoms of conjunctivitis were prospectively enrolled from September 2018 to March 2020. A swab of the affected eye was applied to the LE test strip and another swab was sent for culture processing. The primary outcome was the association between LE test results and eye culture results.

RESULTS RESULTS

We enrolled 189 patients. Overall, 117 eye cultures (62%) were positive. The sensitivity and specificity of LE testing was 96% (95% CI 90-98%) and 14% (95% CI 7-25%), respectively. Positive predictive value was 64% (95% CI 57-71%) and negative predictive value was 67% (95% CI 39-87%).

CONCLUSIONS CONCLUSIONS

The LE test strip had limited ability to differentiate bacterial conjunctivitis from other etiologies.

Identifiants

DOI: 10.1016/j.jemermed.2023.11.003 PMID: 38309981

pubmed: 38309981

pii: S0736-4679(23)00547-4

doi: 10.1016/j.jemermed.2023.11.003

pii:

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Informations de copyright

Déclaration de conflit d'intérêts

Declaration of competing interest None.