To evaluate the diagnostic efficacy of urinalysis in the diagnosis of pediatric urinary tract infection

Abstract

Objective: Complete urinalysis and urine culture are commonly used as diagnostic methods for urinary tract infections AI). In this study, we sought to determine the diagnostic value of urinalysis and microscopic examination in children with suspect UTI.

Methods: The study included 183 patients, with 111 positive and 72 negative urine cultures. The symptoms, such as fever, vomiting, anorexia, pollakiuria and abdominal pain, were considered as signs of UTI. The diagnostic accuracy of the test parameters that may be indicators of 1171 in biochemical and microscopic examination of the urine were estimated.

Results: Leukocyte esterase activity had the highest sensitivity (98.1%) but low specificity (54.6%). Nitrate positivity had the highest specificity (100%) but low sensitivity (45.2%). In general, in combined assessments increased specificity but decreased sensitivity rates were detected. The highest specificity was detected for the combination of nitrite and leukocyte esterase (97.4%); however, this combination showed low sensitivity (56.8%). Nitrite positivity was the best parameter for positive predictive value (100%), but it had a low negative predictivity (21.6%). Leukocyte esterase positivity (98.6%) and presence of leukocytes greater than five in per microscopic field of vision (93.1%) were the best parameters for negative predictive values, but they had low positive predictivity (46.8 and 50.5%, respectively).

Conclusion: We have found that many parameters and microscopic urinalysis data had a high sensitivity for 1111 diagnosis, however all of these parameters also had low specificity. Since there was no single analysis parameter that simultaneously possessed high sensitivity and specificity, we believe that UTI diagnosis should be confirmed by culture.