Comparative Study of Dipstick, Urine Microscopy and Urine Culture in the Diagnosis of Urinary Tract Infection in Children Under Five Years
Kerbala Journal of Medicine,
2010, Volume 3, Issue 6, Pages 822-828
Abstractbackground: Urinary tract infection is a common source of bacterial infection
in children under five years old; urinalysis is one of the important and useful
urological tests for diagnosis of infection, microscopic examination of urine
and the dipstick urinalyses (leukocytes esterase test, nitrite test) are common tests
used for detecting bacteriurea and pyuria.
Objective: Comparison of the rapid tests: dipstick (leukocytes esterase test, nitrite
test), microscopic examination, and urine culture in detecting urinary tract infection in
children under five years old.
Method: The study conducted on 246 patients less than 5 years old admitted with
clinical suspicion of urinary tract infection in Kerbala pediatric teaching hospital in
the period from July to December 2008. All urine samples were collected then
submitted for routine urinalysis and bacterial culture, dipstick and microscopy were
Results: Urinary tract infection was identified in117 patients, The sensitivity of
leukocytes esterase test was 83.7% higher than nitrite test 39.3%while specificity
was70% which is lower than nitrite test 87.6%, the positive predictive value and
negative predictive value for nitrite test were 74%, 61% respectively while for
leukocytes esterase test record 76.6%, 82% respectively.
The positive predictive value and negative predictive value for pyuria( 96.2%, 99.1%)
were higher than that recorded in both nitrite test and leukocytes esterase.
Conclusion: 1-The dipstick tests (nitrite and leukocyte esterase) have high positive
predictive value for presence of urinary tract infection.
2- The high negative predictive value of these tests doesn't exclude urinary tract
3-Acombination of microscopic examination and dipstick tests improve the sensitivity
of detecting urinary tract infections.
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