Urine dipstick test for diagnosing urinary tract infection

  • Syarifah Julinawati Department of Child Health, University of Sumatera Utara Medical School
  • Oke Rina Department of Child Health, University of Sumatera Utara Medical School
  • Rosmayanti Rosmayanti Department of Child Health, University of Sumatera Utara Medical School
  • Rafita Ramayati Department of Child Health, University of Sumatera Utara Medical School
  • Rusdidjas Rusdidjas Department of Child Health, University of Sumatera Utara Medical School
Keywords: dipstick urine, urine culture, urinary tract infection

Abstract

Background Urinary tract infection (UTI) is a common disease
in children. Approximately 3-5% of girls and 1 % of boys develop
a UTI. In children, prompt treatment is essential because UTI
may be a risk factor for developing renal insufficiency or end stage
renal disease. Howevet; prompt treatment depends on having a
rapid diagnosis. Urine dipstick testis a useful and commonly used
because it is low cost and gives rapid results, compared to urine
cultures for diagnosing UTis. However, the diagnostic accuracy
of the urine dipstick test is debatable.
Objective To compare urine dipstick test (leukocyte esterase,
nitrite, and combined leukocyte es terase and nitrite) to urine
culture for diagnosing UTis.
Methods A diagnostic study was held in H. Adam Malik Hospital
from May to June 2010. There were 70 children aged 2 to 14
years and recruited by consecutive sampling. Two midstream
urine specimens were collected from subjects after cleaning the
external urethral orifice. The first specimen was used for urine
dipstick testing for leukocyte esterase and nitrite. The second
urine specimen was cultured in the laboratory. Urinalysis for
leukocyte esterase and nitrite studies were performed with fresh
and uncentrifuged urine. Leukocyte esteras e and nitrite caused
a change in dipstick color apparent within 2 minutes. Urinalyses
were considered to be positive for UTI if either leukocyte esterase
or nitrite were positive. The results of urine culture were used as
the golden standard.
Results The sensitivities of leukocyte esterase and nitrate
tests were 90 .5% and 73.8%, respectively. However, the
sensitivity for combined leukocyte esterase and nitrite test
was 96.4%. Nitrite test was more specific (60.7%) than the
leukocyte esterase test (39.3%). The specificity of both tests
taken together was 64.3% . For leukocyte esterase alone, nitrate
alone, and the two combined the positive predictive values
(PPV) were 69.1 %, 73.8%, and 64.3.%, respectively, and the
negative predictive values (NPV) were 73.3%, 60.7%, and
96.4%, respectively.
Conclusion Urine dipstick test for leukocyte esterase and nitrite
combined may be a good alternative diagnostic test for UTis in
children than leukocyte esterase or nitrite by themselves in areas
with limited resources.

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Published
2013-12-30
How to Cite
1.
Julinawati S, Rina O, Rosmayanti R, Ramayati R, Rusdidjas R. Urine dipstick test for diagnosing urinary tract infection. PI [Internet]. 30Dec.2013 [cited 17Apr.2024];53(6):315-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/369
Received 2016-08-29
Accepted 2016-08-29
Published 2013-12-30