COMPARISON OF URINE DIPSTICK WITH URINE CULTURE IN DIAGNOSIS OF URINARY TRACT INFECTION IN CHILDREN.

Abstract

BACKGROUND: Urinary tract infection (UTI) is a common cause of morbidity in the paediatric age group. In general practice, 6-8% of febrile infants who are unwell and older children having urinary complaints will have UTI. It may lead to long- term complications like loss of normal function, renal scarring and hypertension. Thus, prompt detection and treatment of UTI is important. AIMS AND OBJECTIVES: 1. To evaluate the accuracy of dipstick leukocyte esterase and nitrite tests for rapid screening of urine samples, keeping semi quantitative Urine culture as the gold standard for the diagnosis of UTI. 2. To study the clinical prole of UTI in children. METHOD: A hospital based, prospective, cross sectional study was conducted with a total of 100 febrile children between the age of 1year to less than 18 years who came to department of Paediatrics, MMIMSR, both inpatient and out-patient department were included in the study. Two urine samples were collected out of which one was sent for urine culture and the other was used for urine dipstick test and urinalysis. RESULTS: Out of 100 febrile children suspected to have UTI, Urine culture was found to be positive in 49% cases. E.coli was found to be the most common organisms causing UTI. Out of 49% culture positive cases, 55% were females. The most common age group to have culture positivity was found to be 12 years to less than 18 years of age. The most common features associated with culture positive UTI were found to be vomiting and pain abdomen along with fever. The leukocyte esterase test and nitrite test have a sensitivity and specicity of 81.63%, 88.24% and 32.65%, 96.08% respectively. Thus, leukocyte esterase can be used to screen UTI in paediatric age group. Microscopic urinalysis is comparable to leukocyte esterase with sensitivity of 73.47% and specicity of 92.16%. When leukocyte esterase and nitrite tests are used in combination, the sensitivity increases to 86% and specicity to 88%. When all three are used together the ability to diagnose UTI improves further. CONCLUSION: Urine dipstick test (leukocyte esterase and nitrite reduction test), is a rapid and feasible method to screen urinary tract infection in children.