BACKGROUND Accurately diagnosing urinary tract infections (UTI) in children with neuropathic bladders can be difficult given the lack of specificity of both clinical symptoms and routine screening tests. We aimed to identify a priori unknown classes/groups of children with neuropathic bladder with respect to symptoms and UA results and examine their relationships with odds of UTI. METHODS We used latent class analysis (LCA) to identify unobserved classes/groups of children with neuropathic bladder based on symptoms and urinalysis (UA) results, respectively. Demographic and clinical data were gathered by retrospective chart review of a cohort with neuropathic bladder. Symptoms and UA results were obtained by chart review of visits where urine culture was ordered. RESULTS Around 193 patients were included in UA results analysis and 179 in symptom-based analysis. Two latent classes of patients were identified with respect to symptoms, labeled "pyelonephritis class" and "cystitis class," and two, with respect to UA results, were labeled "positive UA class" and "negative UA class." The pyelonephritis class had significantly higher odds of UTI compared to the asymptomatic class. While odds of UTI in cystitis class were higher than the asymptomatic class, this difference was not statistically significant. Positive UA class had significantly higher odds of UTI compared to negative UA class. CONCLUSION Two unobserved classes/groups exist in children with neuropathic bladder with respect to symptoms, corresponding to cystitis and pyelonephritis, and two classes of UA results that correspond with either a positive or negative UA. Our results suggest a differential approach to treatments may be considered.

中文翻译：

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基于症状和尿液分析的方法可诊断神经性膀胱患儿的尿路感染。

背景技术由于缺乏临床症状和常规筛查测试的特异性，因此难以准确诊断患有神经性膀胱炎的儿童的尿路感染（UTI）。我们旨在从症状和UA结果方面确定先天性未知的神经病理性膀胱疾病儿童的类别/组，并检查他们与UTI几率的关系。方法我们使用隐性类分析（LCA）分别根据症状和尿液分析（UA）结果来识别未观察到的神经病性膀胱儿童的类/组。通过回顾性研究神经病性膀胱癌队列的人口统计和临床数据。症状和UA结果是通过对订购尿培养的访视进行图表审查获得的。结果约有193例患者被纳入UA结果分析，而179例基于症状的分析。根据症状确定了两个潜在的患者类别，分别标记为“肾盂肾炎分类”和“膀胱炎分类”，关于UA结果，将两个分类为“阳性UA分类”和“阴性UA分类”。与无症状类别相比，肾盂肾炎类别的UTI几率明显更高。虽然膀胱炎类中UTI的几率高于无症状类，但这种差异在统计学上并不显着。与阴性UA级相比，阳性UA级的UTI机率要高得多。结论神经性膀胱疾病的儿童在症状方面存在两个未观察到的类别/组，分别对应于膀胱炎和肾盂肾炎，和两类UA结果，分别对应于阳性UA或阴性UA。我们的结果表明可以考虑采用不同的治疗方法。