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Profile of children with urinary tract infection and the utility of urine dipstick as a diagnostic tool.
J Nepal Health Res Counc. 2014 Sep-Oct; 12(28):151-5.JN

Abstract

BACKGROUND

Urinary tract infection is a common problem in children and its early diagnosis and treatment is important to prevent long-term complications. Urine dipstick can be an important tool in this respect. The aim of this study is to look at the utility of urine dipstick as a diagnostic tool for UTI and will also see the clinical profile of children with UTI and sensitivity pattern of antibiotics among the isolates of urine culture.

METHODS

Urine samples of all children below 14 years of age who were suspected of urinary tract infection were sent for routine microscopic examination and dipstick testing. Urine culture and sensitivity were sent for those samples that were tested positive for nitrite, leucocyte esterase activity or both. For every fifth sample, which is dipstick negative, a culture and sensitivity testing was done.

RESULTS

Among 110 children enrolled, 32(29%) cases had significant bacteriuria. Out of 32 culture positive cases 18(56%) were female. Fever was the main complaint (62.5%)). Escherichia Coli was isolated in 81.25% of cases. Amikacin was sensitive in 93% and amoxicillinwas resistant in 82%. The sensitivity, specificity, positive predictive value, negative predictive value of nitrite test was 65%, 80%, 58%, 85% respectively; those of leucocyte esterase are 84%, 55%, 43%, 89% respectively; those for significant microscopic pyuria >10/hpf were 65%, 74%, 51%, 84% respectively.

CONCLUSIONS

E. Coli is the commonest uropathogen in children with UTI. Amikacin is the most sensitive antibiotic against all the isolates. A positive dipstick both for nitrite and leucocyte esterase is associated with high sensitivity and specificity for urinary tract infection as compared to either of them positive alone. In addition, urine WBC ≥10/hpf is associated with high probability of UTI.

Authors+Show Affiliations

Ojha AR
Kathmandu Medical College, Sinamangal, Kathmandu, Nepal.
Aryal UR
Kathmandu Medical College, Sinamangal, Kathmandu, Nepal.

MeSH

AdolescentAmikacinAmoxicillinAnti-Bacterial AgentsBacteriuriaChildChild, PreschoolCross-Sectional StudiesEscherichia coli InfectionsFemaleHumansInfantLeukocyte CountMaleMicrobial Sensitivity TestsReagent StripsSensitivity and SpecificityUrinary Tract Infections

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26032050

Citation

Ojha, A R., and U R. Aryal. "Profile of Children With Urinary Tract Infection and the Utility of Urine Dipstick as a Diagnostic Tool." Journal of Nepal Health Research Council, vol. 12, no. 28, 2014, pp. 151-5.
Ojha AR, Aryal UR. Profile of children with urinary tract infection and the utility of urine dipstick as a diagnostic tool. J Nepal Health Res Counc. 2014;12(28):151-5.
Ojha, A. R., & Aryal, U. R. (2014). Profile of children with urinary tract infection and the utility of urine dipstick as a diagnostic tool. Journal of Nepal Health Research Council, 12(28), 151-5.
Ojha AR, Aryal UR. Profile of Children With Urinary Tract Infection and the Utility of Urine Dipstick as a Diagnostic Tool. J Nepal Health Res Counc. 2014 Sep-Oct;12(28):151-5. PubMed PMID: 26032050.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Profile of children with urinary tract infection and the utility of urine dipstick as a diagnostic tool. AU - Ojha,A R, AU - Aryal,U R, PY - 2015/6/3/entrez PY - 2015/6/3/pubmed PY - 2015/12/15/medline KW - dipstick; sensitivity; specificity; urinary tract infection. SP - 151 EP - 5 JF - Journal of Nepal Health Research Council JO - J Nepal Health Res Counc VL - 12 IS - 28 N2 - BACKGROUND: Urinary tract infection is a common problem in children and its early diagnosis and treatment is important to prevent long-term complications. Urine dipstick can be an important tool in this respect. The aim of this study is to look at the utility of urine dipstick as a diagnostic tool for UTI and will also see the clinical profile of children with UTI and sensitivity pattern of antibiotics among the isolates of urine culture. METHODS: Urine samples of all children below 14 years of age who were suspected of urinary tract infection were sent for routine microscopic examination and dipstick testing. Urine culture and sensitivity were sent for those samples that were tested positive for nitrite, leucocyte esterase activity or both. For every fifth sample, which is dipstick negative, a culture and sensitivity testing was done. RESULTS: Among 110 children enrolled, 32(29%) cases had significant bacteriuria. Out of 32 culture positive cases 18(56%) were female. Fever was the main complaint (62.5%)). Escherichia Coli was isolated in 81.25% of cases. Amikacin was sensitive in 93% and amoxicillinwas resistant in 82%. The sensitivity, specificity, positive predictive value, negative predictive value of nitrite test was 65%, 80%, 58%, 85% respectively; those of leucocyte esterase are 84%, 55%, 43%, 89% respectively; those for significant microscopic pyuria >10/hpf were 65%, 74%, 51%, 84% respectively. CONCLUSIONS: E. Coli is the commonest uropathogen in children with UTI. Amikacin is the most sensitive antibiotic against all the isolates. A positive dipstick both for nitrite and leucocyte esterase is associated with high sensitivity and specificity for urinary tract infection as compared to either of them positive alone. In addition, urine WBC ≥10/hpf is associated with high probability of UTI. SN - 1999-6217 UR - https://www.unboundmedicine.com/medline/citation/26032050/Profile_of_children_with_urinary_tract_infection_and_the_utility_of_urine_dipstick_as_a_diagnostic_tool_ DB - PRIME DP - Unbound Medicine ER -