Comparison of Dipstick Testing of Nitrite and Leukocyte Esterase with Urine Culture for Diagnosing Urinary Tract Infections in Children Between 2-12 Years of Age

Abstract

UTI is a common bacterial infection in children that requires early diagnosis to prevent complications such as a recurrent infection, kidney scarring and non-functioning kidney. Although urine culture is considered to be the gold standard when diagnosing UTI, it also takes time and may slow down the making of treatment decisions. The aim of the research was to compare the diagnostic efficacy of urine dipstick test on nitrite and leukocyte esterase and urine culture in children aged 2-12 years. One hundred and fifty of children with a clinical suspicion of UTI were taken through a cross-sectional and comparative study which was conducted within a hospital setting. The urine samples were examined by use of a dipstick and then the urine culture. Sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy were used to determine diagnostic performance. Results indicated that the leukocyte esterase was more sensitive in the identification of culture-confirmed UTIs whereas the nitrite had greater specificity. The combination of both parameters of the dipstick was related to greater diagnostic accuracy and greater confidence with diagnosing the actual infections. However urine culture was still required to confirm the diagnosis, causing organism, and antimicrobial susceptibility. The conclusion of this study is that urine dipsticks are a fast, inexpensive and effective screening tool that can be utilized to complement the urine culture in the diagnosis of the urinary tract infection in the kids. Its daily application can help in clinical decision making earlier and the initiation of the relevant treatment promptly as the definitive culture results are awaited.