title: Profile of children with urinary tract infection and the utility of urine dipstick as a diagnostic tool.
abstract: BACKGROUND
  Urinary tract infection is a common problem in children and its early diagnosis and treatment is important to prevent long-term complications. Urine dipstick can be an important tool in this respect. The aim of this study is to look at the utility of urine dipstick as a diagnostic tool for UTI and will also see the clinical profile of children with UTI and sensitivity pattern of antibiotics among the isolates of urine culture.
  
  
  METHODS
  Urine samples of all children below 14 years of age who were suspected of urinary tract infection were sent for routine microscopic examination and dipstick testing. Urine culture and sensitivity were sent for those samples that were tested positive for nitrite, leucocyte esterase activity or both. For every fifth sample, which is dipstick negative, a culture and sensitivity testing was done.
  
  
  RESULTS
  Among 110 children enrolled, 32(29%) cases had significant bacteriuria. Out of 32 culture positive cases 18(56%) were female. Fever was the main complaint (62.5%)). Escherichia Coli was isolated in 81.25% of cases. Amikacin was sensitive in 93% and amoxicillinwas resistant in 82%. The sensitivity, specificity, positive predictive value, negative predictive value of nitrite test was 65%, 80%, 58%, 85% respectively; those of leucocyte esterase are 84%, 55%, 43%, 89% respectively; those for significant microscopic pyuria >10/hpf were 65%, 74%, 51%, 84% respectively.
  
  
  CONCLUSIONS
  E. Coli is the commonest uropathogen in children with UTI. Amikacin is the most sensitive antibiotic against all the isolates. A positive dipstick both for nitrite and leucocyte esterase is associated with high sensitivity and specificity for urinary tract infection as compared to either of them positive alone. In addition, urine WBC ≥10/hpf is associated with high probability of UTI.
authors.affiliation: Kathmandu Medical College, Sinamangal, Kathmandu, Nepal.
authors.forename: A R
authors.initials: AR
authors.lastname: Ojha
authors.affiliation: Kathmandu Medical College, Sinamangal, Kathmandu, Nepal.
authors.forename: U R
authors.initials: UR
authors.lastname: Aryal
mesh_terms: D000293:Adolescent; D000583:Amikacin / Q000627:therapeutic use; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001437:Bacteriuria / Q000175:diagnosis / Q000652:urine; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000188:drug therapy / Q000652:urine; D005260:Female; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D008297:Male; D008826:Microbial Sensitivity Tests; D011934:Reagent Strips; D012680:Sensitivity and Specificity; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000652:urine
chemical_list: D000900:Anti-Bacterial Agents; D011934:Reagent Strips; D000658:Amoxicillin; D000583:Amikacin
keywords: dipstick; sensitivity; specificity; urinary tract infection.