Abstract
In 376 children, between 6 months and 5 years of age, with suspected urinary tract infection, 4 parameters of a routine urine examination were correlated with culture reports. In diagnosing urinary infection, the sensitivity and specificity of proteinuria was 79 and 80% respectively, that of bacteriuria 78 and 96% and that of pyuria >10 wbc/hpf 80 and 82% respectively. 61% among the culture positive groups had all these three parameter present, as against only 0.5% in the culture negative group (P<0.001). All these 3 parameters were absent in 70% in the culture negative group, as against 8% in the culture positive group (P<0.001). Bacteriuria in association with either proteinuria or Pyuria >10 Wbc/hpf had 98% specialty is diagnosis. In diagnosis UTI, Pyuria >10 wbc/hpf was significantly more specific (82∶66.6) than the conventional >5 wbc/hpf. Isolated proteinuria, isolated pyuria, isolated bacteriuria and microscopic haematuria were not features of urinary tract infection in children. Urine culture can be more selectively done if the routine urinalysis is well interpreted. In the absence of dependable culture facilities, a routine urine examination can be reliably used in the diagnosis of UTI in children.
Similar content being viewed by others
References
Bollgren I, Engstrm CF, Hammarlind M et al. Low urinary counts of P-fimbriated. Escherichia in children with presumed acute pyelonephritis.Arich Dis Child 1984; 59: 102.
Jequier S, Borges, Forbes P. et al. The value of ultrasound examination as a screening procedure in first documented urinary tract infection in children.Pediat Radiol 1983; 13: 173.
Lohr JA. Use of routine urinalysis in making a presumptive diagnosis of urinary tract infection in children.Pediatr Infect Dis J. 1991; 10: 646–650.
Stansfeld JM. The measurement and meaning of pyuria.Arch Dis Child 1962; 37: 257–262.
Kas EH, Finland M. Asymptomatic infections of the urinary tract.Trans Assoc Am Physicians 1956; 69: 56–64.
Pryles CV, Eliot CR. Pyuria and bacteriuria in infants and children.AJDC 1965; 110: 628–635.
Goldsmith BM, Campos JM. Comparison of urine dipstick, microscopy and culture for the detection of bacteriuria in children.Clin Pediatr 1990; 29: 214–218.
Weinberg AG, Gan VN. Urine screen for bacteriuria in symptomatic pediatric outpatients.Pediatr Infect Dis J 1991; 10: 651–654.
Bailey BL. Urinalysis predictive of urine culture results.J fam Pract 1995; 40 (1): 45–50.
Stamm WE. Measurement of pyuria and its relation to bacteriuria.Am J Med 1983; 75 (Suppl): 53–58.
Alwall N. Pyria deposit in high power microscopic field wbc/hpf versus wbc/mm in counting chamber.Acta Med Scand 1973; 194: 537–540.
Vickers D, Ahmad T, Coulthrad MG. Diagnosis of urinary tract infection in Children: Fresh urine microscopy or culture.Lancet 1991; 338: 8770: 767–770.
Pylkkanen J, Vilska J, Koshimies O. Diagnostic value of symptoms and clean Voided urine specimen in childhood urinary tract infection.Acta Pediatr Scand 1979; 68 (3): 341–344.
Jenkins RD, Fenn JP, Matsen JM. Review of urine microscopy for bacteriuria. JAMA 1986; 255 (24): 3397–3403.
Hoberman A, Wald ER, Reynolds EA, Penchansky L, Charron M. Pyuria and bacteriuria in urine specimens obtained by cathether from young children with fever.J Pediatr 1994; 124 (4): 513–519.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Matthai, J., Ramaswamy, M. Urinalysis in urinary tract infection. Indian J Pediatr 62, 713–716 (1995). https://doi.org/10.1007/BF02825125
Issue Date:
DOI: https://doi.org/10.1007/BF02825125