Diagnostic tests of microscopic and urine dipstick examination in children with urinary tract infection

Background Urinary tract infection (UTI) is common in children and, if incorrectly handled, may cause long-term complications, such as renal failure. The best test to diagnose UTIs is urine culture. However, urine culture is time-consuming, taking 3 - 5 days. Therefore, there is a need for faster, alternative methods. Urinalysis is a common diagnostic test to establish the diagnosis of UTI. Objective To determine the sensitivity and specificity of urine leukocytes, nitrite and leukocyte esterase for UTIs diagnosis. Methods We performed diagnostic tests at Dr. Sardjito Hospital, Yogyakarta. We examined the presence of leukocytes in urine by microscopy,urinary nitrite and leukocyte esterase by dipstick test, while comparing to urine culture as the gold standard. Results Two hundred children were included in our study. By parallel test analysis, we found the sensitivity, specificity, positive predictive value and negative predictive value of using all 3 tests in combination were 95%, 59%, 74% and 89%, respectively Conclusion Test for urine leukocytes, nitrite and leukocyte esterase have high sensitivity but low specificity for diagnosing UTIs. Therefore, negative results in these 3 tests do not rule out the possibility of UTI in children. [Paediatr Indones. 2011 ;51;252-5]