ESPN 50th Annual Meeting

ESPN 2017


 
FACTORS THAT INFLUENCE DIPSTICKS SENSITIVITY IN URINARY TRACT INFECTION DIAGNOSIS
RAQUEL OLIVEIRA 3 ANA RAQUEL MENDES 1 LILIANA TEIXEIRA 1 LIANE CORREIA-COSTA 2 LILIANA ROCHA 2 PAULA MATOS 2

1- DEPARTMENT OF PEDIATRICS, CENTRO MATERNO-INFANTIL DO NORTE, CENTRO HOSPITALAR DO PORTO, E.P.E., PORTUGAL
2- DEPARTMENT OF PEDIATRIC NEPHROLOGY, CENTRO MATERNO-INFANTIL DO NORTE, CENTRO HOSPITALAR DO PORTO, E.P.E., PORTUGAL
3- DEPARTMENT OF PEDIATRICS, UNIDADE LOCAL DE SA├║DE DO ALTO MINHO, VIANA DO CASTELO, PORTUGAL
 
Introduction:

The authors aimed to analyze the influence of age, sex, uropathy, vesicoureteral reflux (VUR), fever and prophylaxis on dipsticks sensitivity in urinary tract infection (UTI) diagnosis.

Material and methods:

Retrospective analysis of positive urine culture results from children and adolescents aged <18 years, during the year of 2015, in a tertiary hospital. Children submitted to renal transplant, with asymptomatic UTI or neuropathic bladder were excluded from the analysis. Statistical comparisons between categorical variables were performed by chi-square tests.

Results:

A total of 219 positive urine cultures were analyzed, corresponding to 174 patients (68.4% female) with a median age of 3 years. The most common pathogens identified were E. coli (69.4%), P. mirabilis (13.7%), E. faecalis (5%) and K. pneumonia (4.6%). Altered dipsticks test results corresponded to urine sediment alterations in 92.5% (vs. 7.5%, p<0.001).Regarding age distribution, dipsticks test alterations were most frequent in children aged >3 yr (13.4% vs.38.1% vs.48.5%, in <3 mo, 3mo-3yr, >3yr, p=0.011). With regards to the sex distribution, there was a significant rate of alterations in the dipsticks test for males (74.4%) and females (88.7%), although higher in the female sex (76.1% vs. 23.9%, p=0.026). Dipsticks sensitivity was higher for E. coli UTI compared to other agents (73.9% vs. 26.1%, p=0.002). The presence of uropathy, VUR, antibiotic prophylaxis or the presence of fever had no impact on sensitivity of dipsticks test.

Conclusions:

Rapid urine tests, such as dipsticks and urine sediment analysis are frequently used to guide early diagnosis and treatment of UTI, being often performed at that same time. In the present study, the authors conclude that dipsticks is equivalent to urine sediment when dealing with a suspected UTI, allowing for a rapid and cheap approach. Of all factors analyzed only age and sex had an impact on dipsticks test sensitivity.