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

Öz

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.

Anahtar Kelimeler

• idrar yolu enfeksiyonu
• lökosit esteraz
• nitrit
• tam idrar tetkiki

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

Öz

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.

Anahtar Kelimeler

• urinary tract infections
• leukocyte esterase
• nitrite
• urinalysis

Kaynakça

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