Urine analysis sensitivity and specificity for paediatric urinary tract infections

BackgroundPaediatric urinary tract infection (UTI) is one of the most common infections among children and a reliable method for diagnosis is critical for management. Few studies have discussed the relationship between the number of leukocytes in the microscopic urinalysis and urine culture.AimsOur aim was to determine the sensitivity and specificity of pyuria as a predictor of culture- proven UTI in the paediatric age group.MethodsThis retrospective study was conducted between 2015 and 2020 at King Abdulaziz University Hospital. Demographic data, history of congenital anomalies, and microscopic urine analysis of 315 participants (≤ 14 years old) was analysed. Pyuria was defined as > 5 WBC /HPF.ResultsUTI was diagnosed in 115 patients based on urine culture. The most common organism was Escherichia coli. Non-E. coli UTI are more common with vesicoureteral reflux patients. Pyuria was found to be positive in 134 (42.5 per cent) of the total sample; 80 of them had a confirmed UTI, with sensitivity of 70 per cent and specificity of 73 per cent. Nitrite has a high sensitivity (66 per cent) but a low specificity. The association between pyuria and positive urine culture was strongly and independently significant (P=0.001). Pyuria and nitrite positivity appear to be more sensitive to E. coli.ConclusionIn conclusion, pyuria is a strong predictor for urinary tract infection in the paediatric age group and is a wise initial test