Cureus · 2026
Role of Urine Dipstick Screening in the Diagnosis of Pediatric Urinary Tract Infection in an Urban Referral Centre in Tamil Nadu, India.
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Arokiadas Jane Allen Christa, Manokaran Vasanthakumar, Arulmozhi Madhivanan, I Reshma
Аннотация
INTRODUCTION: Urinary tract infection (UTI) is the most prevalent bacterial illness among children and a common cause of fever without an identifiable focus. Diagnosing UTI in children can be challenging, as their symptoms are nonspecific. Timely and accurate diagnosis is essential to prevent renal damage and reduce unnecessary interventions. Dipstick tests offered a rapid, non-invasive, and cost-effective alternative to urine culture, particularly in resource-limited settings.
OBJECTIVES: This study aimed to evaluate the diagnostic performance of urine dipstick screening, specifically nitrite and leukocyte esterase tests, in detecting pediatric UTIs in an urban referral centre in Tamil Nadu.
METHODOLOGY: A cross-sectional diagnostic study was conducted among 140 children aged two months to 12 years, presenting with symptoms suggestive of UTI. Urine samples were collected under aseptic conditions and tested using dipstick strips, microscopy, and culture. Nitrite and leukocyte esterase served as surrogate markers, enabling early identification and triage.
RESULTS: Among the 140 children enrolled, infants constituted the largest age group (37.9%), and fever was the predominant symptom, reported in 90% of cases. The sensitivity and specificity of nitrite was 30% and 97.5%, whereas leucocyte esterase showed values of 55% sensitivity and 85% specificity. When compared to urine culture, the combined Nitrite and Leucocyte esterase test has good specificity (99.2%) and negative predictive value (89.5%) to rule out UTI, when both markers are negative.
CONCLUSION: Urine dipstick screening can effectively rule out UTI and help in the identification of children requiring further diagnostic evaluation, reducing unnecessary cultures and facilitating prompt treatment, especially in limited laboratory settings. By streamlining diagnosis and minimizing delays, dipstick screening contributes to improved pediatric UTI management and prevention of long-term complications.
OBJECTIVES: This study aimed to evaluate the diagnostic performance of urine dipstick screening, specifically nitrite and leukocyte esterase tests, in detecting pediatric UTIs in an urban referral centre in Tamil Nadu.
METHODOLOGY: A cross-sectional diagnostic study was conducted among 140 children aged two months to 12 years, presenting with symptoms suggestive of UTI. Urine samples were collected under aseptic conditions and tested using dipstick strips, microscopy, and culture. Nitrite and leukocyte esterase served as surrogate markers, enabling early identification and triage.
RESULTS: Among the 140 children enrolled, infants constituted the largest age group (37.9%), and fever was the predominant symptom, reported in 90% of cases. The sensitivity and specificity of nitrite was 30% and 97.5%, whereas leucocyte esterase showed values of 55% sensitivity and 85% specificity. When compared to urine culture, the combined Nitrite and Leucocyte esterase test has good specificity (99.2%) and negative predictive value (89.5%) to rule out UTI, when both markers are negative.
CONCLUSION: Urine dipstick screening can effectively rule out UTI and help in the identification of children requiring further diagnostic evaluation, reducing unnecessary cultures and facilitating prompt treatment, especially in limited laboratory settings. By streamlining diagnosis and minimizing delays, dipstick screening contributes to improved pediatric UTI management and prevention of long-term complications.