Urinalysis as a diagnostic tool for febrile urinary tract infection in children aged 2 months - 2 years

Ayijati Khairina; Partini Pudjiastuti Trihono; Zakiudin Munasir

doi:10.14238/pi54.2.2014.100-8

Ayijati Khairina Department of Child Health, University of lndonesia Medical School
Partini Pudjiastuti Trihono Department of Child Health, University of lndonesia Medical School
Zakiudin Munasir Department of Child Health, University of lndonesia Medical School

DOI: https://doi.org/10.14238/pi54.2.2014.100-8

Keywords: urinalysis, diagrwstic study, febrile, urinary tract infection, children

Abstract

Background Children aged 2 months to 2 years with febrile
urinary tract infection (UTI) need special attention considering
kidney complications, unspecified symptoms, and difficult urine
sample collection. Urinalysis was the main supportive examination
for UTI because of its immediate result and widespread
availability.
Objective To estimate urine nitrite, leukocyte esterase (LE),
leucocyturia, bacteriuria, and their combinations as a diagnostic
tool for febrile UTI in children aged 2 months to 2 years.
Methods This is a diagnostic study held in Cipto Mangunkusumo
Hospital, Tangerang General Hospital, Fatmawati Hospital, and
Budhi Asih Hospital, involving 7 5 children aged 2 months to 2
years. Urine samples for urinalysis and urine culture were collected
using urine collector in all subjects. Clinical pathologists who
performed urine culture, did not know the results of urinalysis.
Results By parallel test analyses, we found that the best diagnostic
value was the combination of 3 tests (LE, leucocyturia, and
bacteriuria). This combination test showed sensitivity, specificity,
positive predictive value (PPV), negative predictive value (NPV),
positive likelihood ratio (LR+), and negative likelihood ratio
(LR-) of 69%, 95%, 85%, 88%, 13.1, and 0.3.
Conclusion The combination test of LE, leucocyturia, and
bacteriuria shows high specificity, NPV, and LR+ . Therefore, the
negative results of these 3 tests in combination can be used to rule
out UTI.

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