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The Association Between Urinalysis and Urine Culture Results in Children Aged 3-6 Years Who Applied to A Pediatric Emergency Clinic at A University Hospital

Year 2023, , 126 - 136, 19.10.2023
https://doi.org/10.55517/mrr.1288127

Abstract

Aim: Urinary tract infection (UTI) is one of the most common infections of childhood. The generation of the causing pathogen in urine culture is the gold standard in diagnosis. However, due to the low likelihood of urine culture, particularly in primary healthcare facilities, and the prolonged results of urine culture, the patient must perform different examinations. In this case, it is thought that urinalysis and urine microscopy may guide physicians. In this study, it is aimed to reveal the role of urinalysis and urinary microscopy in the diagnosis of urinary tract infection. Methods: In this study, 728 children between the ages of 3-6 who applied to the pediatric emergency clinic at a university hospital over a 12-month period and were able to deliver both samples for urinalysis and urine culture were included. Retrospective patient file screening was done using the Hospital Information Management System, and Statistical Software SPSS 18.0 was used to assess the data. Results: 425 (58.4%) female and 303 (41.6%) male patients were included in the study. Patients with urine culture reproduction comprised 30.5% male and 69.5% female. The relationship between urinalysis and urine culture results was found to be statistically significant (p<0.01). Leukocyte esterase had the highest sensitivity with 63.1%. In the logistic regression analysis, it was seen that the presence of dysuria increased the likelihood of urinary tract infection by 3.15 times, the presence of leukocytes in the urine by 2.52 times, the presence of nitrites by 19.76 times, and the presence of bacteria by 13.43 times. Conclusion: Urinalysis and urine microscopy provide guiding information in the diagnosis of urinary tract infections.

References

  • Ishrat NN, Rezwanul AM, Farhana J, Nahar FN. Clinical and Laboratory Profile of Childhood Urinary Tract Infection in a Tertiary Care Hospital of Bangladesh. CODHR-V7 [Internet]. 2023 Feb. 3 [cited 2023 Feb. 27];46-63. Available from: https://stm.bookpi.org/CODHR-V7/article/view/9430
  • Bagga A. Urinary tract infections: evaluation and treatment. Indian journal of pediatrics. 2001;68:S40-5. White B. Diagnosis and treatment of urinary tract infections in children. Am Fam Physician. 2011;83(4):409-415.
  • Tekin M, Konca C, Almis H, Bucak IH, Genc Y, Gunduz A, et al. Cocukluk cagi idrar yolu enfeksiyonu tanisinda tam idrar tetkikinin tanısal etkinliginin irdelenmesi. Journal of Dr Behcet Uz Children's Hospital. 2015;5(2).
  • Mattoo TK, Shaikh N, Nelson CP. Contemporary management of urinary tract infection in children. Pediatrics. 2021;147(2).
  • Swetha M, Ravindranath C, Divya H. Antimicrobial susceptibility pattern in Escherichia coli causing urinary tract infection among children. International Journal of Medical Reviews and Case Reports. 2023;6(18):69-.
  • Leung AK, Wong AH, Leung AA, Hon KL. Urinary tract infection in children. Recent patents on inflammation & allergy drug discovery. 2019;13(1):2-18.
  • Shaikh N, Shope TR, Hoberman A, Vigliotti A, Kurs-Lasky M, Martin JM. Association between uropathogen and pyuria. Pediatrics. 2016;138(1).
  • Nyayadhish R, Mishra K, Kumar M, Saigal K. Identification of Probable Urinary Tract Infection in Children Using Low Bacterial Count Thresholds in Urine Culture. Indian Pediatrics. 2023:S097475591600488-S.
  • Pouladfar G, Basiratnia M, Anvarinejad M, Abbasi P, Amirmoezi F, Zare S. The antibiotic susceptibility patterns of uropathogens among children with urinary tract infection in Shiraz. Medicine. 2017;96(37).
  • National Institute for Health and Clinical Excellence (NICE). Urinary tract infection in children. Available at: https://www.nice.org.uk/Guidance/cg54 [Last Accessed 23 February 2023].
  • Downing H, Thomas-Jones E, Gal M, Waldron C-A, Sterne J, Hollingworth W, et al. The diagnosis of urinary tract infections in young children (DUTY): protocol for a diagnostic and prospective observational study to derive and validate a clinical algorithm for the diagnosis of UTI in children presenting to primary care with an acute illness. BMC infectious diseases. 2012;12(1):1-15.
  • Alper BS, Curry SH. Urinary tract infection in children. American Family Physician. 2005;72(12):2483-8.
  • Ipekci T, Celik O, Aydogdu O, Akand M, Yuksel MB. Uriner sistem enfeksiyonlarina guncel yaklasim. The Cystoscope. 2014;1:73-81.
  • Zorc JJ, Kiddoo DA, Shaw KN. Diagnosis and management of pediatric urinary tract infections. Clinical microbiology reviews. 2005;18(2):417-22.
  • Lee SP, Vasilopoulos T, Gallagher TJ. Sensitivity and specificity of urinalysis samples in critically ill patients. Anaesthesiology Intensive Therapy. 2017;49(3):204-9.
  • Gulcan A, Celik G, Gulcan E, Cansever Z, Aladag DM. Idrar yolu enfeksiyonu supheli hastalarda tam idrar analizi ve kultur sonuclarinin performans degerlendirmesi. Abant Tip Dergisi. 2012;1(2):61-4.
  • Hay AD, Sterne JA, Hood K, Little P, Delaney B, Hollingworth W, et al. Improving the diagnosis and treatment of urinary tract infection in young children in primary care: results from the DUTY prospective diagnostic cohort study. The Annals of Family Medicine. 2016;14(4):325-36.
  • Bodur S, Filiz E. 7-12 yas cocuklarda piyüri sikliginin demografik ozellikler, gecirilmis uriner enfeksiyon ve okul tuvaletini kullanma ile iliskisi. Genel Tip Dergisi. 2011;21(2)
  • Ercan S, Yucel N, Ozer RS, Orcun AK. Yas ve Cinsiyete Gore Idrar Nitrit ve Lokosit Esterazİn Tanİ Performanslari. Turk Klinik Biyokimya Dergisi. 2014;12(2):91-8.
  • Unal B, Delibas A, Kuyucu N. Odagi Belli Olmayan Dusuk Riskli Atesli Cocuklarda Idrar Yolu Enfeksiyonu Sikliği ve Belirlemede Cesitli Idrar Inceleme Yontemlerinin Karsilastirilmasi. Journal of Pediatric Infection/Cocuk Enfeksiyon Dergisi. 2011;5(2).
  • Yang SS, Tsai J-D, Kanematsu A, Han C-H. Asian guidelines for urinary tract infection in children. Journal of Infection and Chemotherapy. 2021;27(11):1543-54.

Bir Üniversite Hastanesi Çocuk Acil Polikliniğine Başvuran 3-6 Yaş Arası Çocuklarda Tam İdrar Tetkiki ile İdrar Kültürü Bulguları Arasındaki İlişki

Year 2023, , 126 - 136, 19.10.2023
https://doi.org/10.55517/mrr.1288127

Abstract

Amaç: İdrar yolu enfeksiyonu (İYE) çocukluk çağının sık enfeksiyonlarındandır. Tanıda altın standart idrar kültüründe etken patojenin üretilmesidir, ancak özellikle birinci basamak sağlık kuruluşlarında idrar kültürü olanağının kısıtlı olması, idrar kültürünün geç sonuçlanması farklı tetkiklerle hastayı değerlendirmeyi gerektirir. Bu durumda tam idrar tetkiki ve idrar mikroskopisinin hekimlere yol gösterici olabileceği düşünülmektedir. Bu çalışmada tam idrar tetkiki ve idrar mikroskopisinin idrar yolu enfeksiyonu tanısındaki yerinin ortaya konması amaçlanmıştır. Yöntem: Araştırmaya 01.01.2016-31.12.2016 tarihleri arasında Adnan Menderes Üniversitesi Uygulama ve Araştırma Hastanesi Çocuk Acil Polikliniğine başvuran, aynı muayenede tam idrar tetkiki ve idrar kültürü istenmiş ve her iki numuneyi de verebilmiş olan 3-6 yaş arası, toplam 728 hasta alındı. Hasta dosyaları Hastane Bilgi Yönetim Sisteminden geriye yönelik tarandı, veriler SPSS 18.0 İstatistik Paket Programı ile değerlendirildi. Bulgular: Çalışmaya 425 (%58,4) kız, 303 (%41,6) erkek hasta alındı. İdrar kültüründe üreme olan hastaların %69,5’i kız, %30,5’i erkekti. Tam idrar tetkiki sonuçlarının idrar kültürü ile ilişkisi istatistiksel olarak anlamlı bulundu (p<0,01). Lökosit esteraz, %63,1 ile en yüksek duyarlılığa sahipti. Lojistik regresyon analizinde dizüri varlığının idrar yolu enfeksiyonu olasılığını 3,15 kat, idrarda lökosit varlığının 2,52 kat, nitrit varlığının 19,76 kat, bakteri varlığının 13,43 kat artırdığı görüldü. Sonuç: İdrar yolu enfeksiyonlarının tanısında tam idrar tetkiki ve idrar mikroskopisi yol gösterici bilgiler vermektedir.

References

  • Ishrat NN, Rezwanul AM, Farhana J, Nahar FN. Clinical and Laboratory Profile of Childhood Urinary Tract Infection in a Tertiary Care Hospital of Bangladesh. CODHR-V7 [Internet]. 2023 Feb. 3 [cited 2023 Feb. 27];46-63. Available from: https://stm.bookpi.org/CODHR-V7/article/view/9430
  • Bagga A. Urinary tract infections: evaluation and treatment. Indian journal of pediatrics. 2001;68:S40-5. White B. Diagnosis and treatment of urinary tract infections in children. Am Fam Physician. 2011;83(4):409-415.
  • Tekin M, Konca C, Almis H, Bucak IH, Genc Y, Gunduz A, et al. Cocukluk cagi idrar yolu enfeksiyonu tanisinda tam idrar tetkikinin tanısal etkinliginin irdelenmesi. Journal of Dr Behcet Uz Children's Hospital. 2015;5(2).
  • Mattoo TK, Shaikh N, Nelson CP. Contemporary management of urinary tract infection in children. Pediatrics. 2021;147(2).
  • Swetha M, Ravindranath C, Divya H. Antimicrobial susceptibility pattern in Escherichia coli causing urinary tract infection among children. International Journal of Medical Reviews and Case Reports. 2023;6(18):69-.
  • Leung AK, Wong AH, Leung AA, Hon KL. Urinary tract infection in children. Recent patents on inflammation & allergy drug discovery. 2019;13(1):2-18.
  • Shaikh N, Shope TR, Hoberman A, Vigliotti A, Kurs-Lasky M, Martin JM. Association between uropathogen and pyuria. Pediatrics. 2016;138(1).
  • Nyayadhish R, Mishra K, Kumar M, Saigal K. Identification of Probable Urinary Tract Infection in Children Using Low Bacterial Count Thresholds in Urine Culture. Indian Pediatrics. 2023:S097475591600488-S.
  • Pouladfar G, Basiratnia M, Anvarinejad M, Abbasi P, Amirmoezi F, Zare S. The antibiotic susceptibility patterns of uropathogens among children with urinary tract infection in Shiraz. Medicine. 2017;96(37).
  • National Institute for Health and Clinical Excellence (NICE). Urinary tract infection in children. Available at: https://www.nice.org.uk/Guidance/cg54 [Last Accessed 23 February 2023].
  • Downing H, Thomas-Jones E, Gal M, Waldron C-A, Sterne J, Hollingworth W, et al. The diagnosis of urinary tract infections in young children (DUTY): protocol for a diagnostic and prospective observational study to derive and validate a clinical algorithm for the diagnosis of UTI in children presenting to primary care with an acute illness. BMC infectious diseases. 2012;12(1):1-15.
  • Alper BS, Curry SH. Urinary tract infection in children. American Family Physician. 2005;72(12):2483-8.
  • Ipekci T, Celik O, Aydogdu O, Akand M, Yuksel MB. Uriner sistem enfeksiyonlarina guncel yaklasim. The Cystoscope. 2014;1:73-81.
  • Zorc JJ, Kiddoo DA, Shaw KN. Diagnosis and management of pediatric urinary tract infections. Clinical microbiology reviews. 2005;18(2):417-22.
  • Lee SP, Vasilopoulos T, Gallagher TJ. Sensitivity and specificity of urinalysis samples in critically ill patients. Anaesthesiology Intensive Therapy. 2017;49(3):204-9.
  • Gulcan A, Celik G, Gulcan E, Cansever Z, Aladag DM. Idrar yolu enfeksiyonu supheli hastalarda tam idrar analizi ve kultur sonuclarinin performans degerlendirmesi. Abant Tip Dergisi. 2012;1(2):61-4.
  • Hay AD, Sterne JA, Hood K, Little P, Delaney B, Hollingworth W, et al. Improving the diagnosis and treatment of urinary tract infection in young children in primary care: results from the DUTY prospective diagnostic cohort study. The Annals of Family Medicine. 2016;14(4):325-36.
  • Bodur S, Filiz E. 7-12 yas cocuklarda piyüri sikliginin demografik ozellikler, gecirilmis uriner enfeksiyon ve okul tuvaletini kullanma ile iliskisi. Genel Tip Dergisi. 2011;21(2)
  • Ercan S, Yucel N, Ozer RS, Orcun AK. Yas ve Cinsiyete Gore Idrar Nitrit ve Lokosit Esterazİn Tanİ Performanslari. Turk Klinik Biyokimya Dergisi. 2014;12(2):91-8.
  • Unal B, Delibas A, Kuyucu N. Odagi Belli Olmayan Dusuk Riskli Atesli Cocuklarda Idrar Yolu Enfeksiyonu Sikliği ve Belirlemede Cesitli Idrar Inceleme Yontemlerinin Karsilastirilmasi. Journal of Pediatric Infection/Cocuk Enfeksiyon Dergisi. 2011;5(2).
  • Yang SS, Tsai J-D, Kanematsu A, Han C-H. Asian guidelines for urinary tract infection in children. Journal of Infection and Chemotherapy. 2021;27(11):1543-54.
There are 21 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Funda Ekimci Deniz 0000-0002-8308-5024

Ayfer Gemalmaz 0000-0003-1366-0289

Publication Date October 19, 2023
Submission Date April 26, 2023
Published in Issue Year 2023

Cite

Vancouver Ekimci Deniz F, Gemalmaz A. The Association Between Urinalysis and Urine Culture Results in Children Aged 3-6 Years Who Applied to A Pediatric Emergency Clinic at A University Hospital. MRR. 2023;6(3):126-3.