Reliability of microscopic urinalysis in predicting urinary tract infection in Children.

Abstract

Urinary tract infections (UTIs) are associated with potentially serious long- term consequences . Up to 7 percent of girls and 2 percent of boys will have a symptomatic, culture-confirmed UTI by six years of age.Most UTIs in children result from ascending infections, colonic bacteria responsible for most of cases. Urinary tract infection may be suspected because of urinary symptoms in older children or because of fever, nonspecific symptoms, or failure to thrive in infants. Eighty one child of age 3.5months -10 years with variable presentation and high clinical suspicion of UTI were recruited for evaluation of UTI on out patient bases over nine –months period, data regarding age , sex was obtained . Urine samples were collected by clean- catch or urine bags .UA was done by microscope for pus cells and urine cultures were carried out.UTIs seems to be highly prevalence among studied children and vary with age and sex and the sensitivity of UA is high(77%)but the specificity is low( 33%) , in agreement with other studies. UA can rule out UTI if the result is negative in cases with low clinical suspicion and positive result is insufficient to diagnose UTI because false positive results are common. However, proper urine culture which required invasive procedure is necessary for diagnosis of urinary tract infections , so the criteria for its use should be optimized.