Abstract

INTRODUCTION

Urinalysis and urine culture are commonly used as investigation methods to diagnosis urinary tract infection (UTI). In this study, we sought to determine the diagnostic value of urinalysis and microscopic examination in children with suspected UTI.

METHODS

The study included 183 patients, and consisted of 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 were, obtained from chemical and microscopic examination of the urine and, that may be indicators of UTI, were calculated.

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, a combined assessment produced increased specificity but decreased sensitivity. The highest specificity was detected through 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 had a low negative predictivity (21.6%). Leukocyte esterase positivity (98.6%) and presence of leukocytes greater than five in per microscopic field (93.1%) were the best parameters for negative predictive values, but had low positive predictivity (46.8 and 50.5%, respectively).

DISCUSSION AND CONCLUSION

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