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Abstract ▼ AI-Helper

Purpose : To evaluate the diagnostic value of dipstick urinalysis($Multistix^{(R)}$) as a screening test for urinary tract infection(UTI) in acute febrile children. Methods : We compared dipstick uinalysis (leukocyte estease(LE) and nitrite) with microscopic urinalysis (WBC and bacteria) ...

Purpose : To evaluate the diagnostic value of dipstick urinalysis($Multistix^{(R)}$) as a screening test for urinary tract infection(UTI) in acute febrile children. Methods : We compared dipstick uinalysis (leukocyte estease(LE) and nitrite) with microscopic urinalysis (WBC and bacteria) and urine culture in 80 children with UTI and 605 children without UTI, who were admitted due to acute fever at EWHA Womans University Hospital between Oct. 1994 and Feb. 1996. Results : 1) In dipstick urinalysis, LE and nitrite were positive in 38.7%, and 13.8% of 80 children with UTI and in 2.1%. and 1.2% of 605 children without UTI. 2) In microscopic urinalysis, WBC and bacteria were positive in 31.2%, and 17.5% of 80 children with UTI and in 4.1%, and 0.6% of 605 children without UTI. 3) Positive rate of LE on dipstick urinalysis was 38.7%, which was significantly higher than 31.5% of WBC on microscopic urinalysis (P<0.05). Positive rate of nitrite was not significantly different to that of bacteria. 4) Sensitivity, specificity, positive predictive value, negative predictive value of dipstick urinalysis were 43.7%, 98.3%, 63.6%, 92.9% which were not significant different to 40.0%, 99.0%, 54.0%, 92.3% of microscopic urinalysis. The sensitivity of combined dipstick and microscopic urinalysis were still low(50%). 5) Additional positive rate of microscopic urinalysis to negative dipstick urinalysis was 6.3%(5/80) in 80 children with UTI. Conclusion : The sensitivity of dipstick urinalysis was low and additional value of microscopic urinalysis was minimal in febrile UTI. So urine culture is mandatory in acute febrile children even though dipstick and microscopic urinalysis are negative.

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