Comparison of urine Gram stain and urine culture to diagnose urinary tract infection in children
Abstract
Background Urinary tract infection (UTI) are due to pathogeninvasion of the urinary tract. The upper or lower tract may be
affected, depending on the presence of infection in the kidney,
or bladder and urethra. Infection of urinary tract affect up to
10% of children and are the most common bacterial infection in
infants and young children worldwide. The prevalence of UTI is
3-5% in girls and 1 % in boys. Urine culture is considered to be
the gold standard diagnostic test for UTI. However, Gram stains
of uncentrifuged urine have been done in rural health centers and
laboratories in peripheral areas that lack facilities to evaluate urine
specimens. Gram stains of urine may be an effective method for
ruling out UTI in rural health center patients, thus saving time
and money in impoverished settings.
Objective To compare urine Gram stain and urine culture as
diagnostic tests for UTI in children.
Methods This cross-sectional study was held in H. Adam Malik
Hospital from May to June 2010. The 54 participants were aged
0 - 14 years, suspected to have UTI and recruited by consecutive
sampling. Urine was collected after the external urethral orifice
was cleaned. A drop of the urine specimen was Gram stained
and examined by a light microscope, while the remainder of the
specimen was used for laboratory urine cultures. If Gram negative
bacteria were observed by Gram stain, we considered the subject
to have UTI.
Results The sensitivity and specificity of urine Gram stain
compared to urine culture were 88% and 100%, respectively. The
positive predictive value (PPV) and negative predictive value
(NPV) were 100% and 90%, respectively.
Conclusion Urine Gram stain may be a good alternative to urine
culture for diagnosing UTI in children living in areas with limited
health care facilities.
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Accepted 2016-08-21
Published 2013-04-30