Diagnostic tests of microscopic and urine dipstick examination in children with urinary tract infection

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Nurul Hidayah
Pungky Ardani Kusum
Noormanto Noormanto


Background Urinary tract infection (UTI) is common in children
and, if incorrectly handled, may cause long-term complications,
such as renal failure. The best test to diagnose UTIs is urine
culture. However, urine culture is time-consuming, taking 3 - 5
days. Therefore, there is a need for faster, alternative methods.
Urinalysis is a common diagnostic test to establish the diagnosis
of UTI.
Objective To determine the sensitivity and
specificity of urine leukocytes, nitrite and leukocyte esterase for
UTIs diagnosis.
Methods We performed diagnostic tests at Dr. Sardjito Hospital,
Yogyakarta. We examined the presence of leukocytes in urine by microscopy,urinary nitrite and leukocyte esterase by dipstick test, while comparing to urine culture as the gold standard.
Results Two hundred children were included in our study. By
parallel test analysis, we found the sensitivity, specificity, positive
predictive value and negative predictive value of using all 3 tests
in combination were 95%, 59%, 74% and 89%, respectively
Conclusion Test for urine leukocytes, nitrite and leukocyte
esterase have high sensitivity but low specificity for diagnosing
UTIs. Therefore, negative results in these 3 tests do not rule
out the possibility of UTI in children. [Paediatr Indones.
2011 ;51;252-5].

Article Details

How to Cite
Hidayah N, Kusum P, Noormanto N. Diagnostic tests of microscopic and urine dipstick examination in children with urinary tract infection. PI [Internet]. 31Oct.2011 [cited 6Apr.2020];51(5):252-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/705
Received 2016-09-27
Accepted 2016-09-27
Published 2011-10-31


1. Zorc JJ, Kiddoo DA, Shaw KN. Diagnosis and management of paediatric urinary tract infections. Clin Microbiol Rev. 2005;1:417-22.
2. Mangatas SM, Suwitra K. Diagnosis dan penatalaksanaan infeksi saluran kemih terkomplikasi. Dexa Medica. 2004;17:12-4.
3. Downs SM. Technical report: Urinary tract infection in febrile infants and young children. Pediatrics. 1999;103:1-6.
4. Rehmani R. Accuracy of urine dipstick to predict urinary tract infections in an emergency department. Pediatrics. 1998;98:101-2.
5. Pusponegoro HD. Uji Diagnostik. Dalam: Sastroasmoro S, Ismael S, editors. Dasar - dasar metodologi penelitian klinis. 2nd ed. Jakarta: Sagung Seto; 2007. p. 166-85.
6. Dickinson JA. Incidence and outcome of symptomatic urinary tract infection in children. Br Med J. 1979;1:1330 -2.
7. Rehman, A, Jahanzeb M, Siddiqui, TS, Idris, M. Frequency and clinical presentation of UTI among children of Hazara Division, Pakistan. J Ayub Med Coll Abbottabad. 2008;20:63-5.
8. Prais D, Straussberg R, Avitzur Y, Nussinovitch M, Harel L, Amir J. Bacterial susceptibility to oral antibiotics in community acquired urinary tract infection. Arch Dis Child. 2003;88:215-8.
9. Waisman Y, Zerem E, Aamir L, Mimouni M. The validity of the uriscreen test for early detection of urinary tract infection in children. Pediatrics. 1999;104:e41.
10. Simerville JA, Maxted WL, Pahira JJ. Urinalysis: a comprehensive review. Am Fam Physic. 2005;71:1153-62.
11. Lohr JA, Portilla MG, Geuder TG, Dunn ML, Dudley SM. Making a presumptive diagnosis of urinary tract infection by using a urinalysis performed in an on-site laboratory. J Pediatr. 1993;122:22-5.