Dicky Adi Putra^1,, Ivan Riyanto Widjaja², Anugrah Sitta Latumahina³, Marsha Zaneta¹, Angelina Armine Susanto Putri⁴, Sudung O. Pardede⁵

Background: Accurate diagnosis of urinary tract infection (UTI) in children is crucial, nevertheless it is an intricate process. Combination parameters such as leukocyte esterase (LE) and leukocyte count in urinalysis as initial laboratory exam for a suspected UTI reported to have a high sensitivity and specificity. Urine culture as the gold standard may take some time, while prompt treatment is imperative. Methods: From July 2016 to June 2018 paired urinalysis and urine culture data from in-patient in Koja General Hospital age 6 months to 18 years old were retrieved. Diagnostic study was done for each individual component i.e. LE, nitrite, bacteria, and leukocytes. Urinary pathogen and antibiotic susceptibility patterns were descriptively analyzed. Results: One-hundred-seventeen data were eligible for analysis. Median age of subjects was 2 years old (6 month-18 years), of which 51.3% were boy. Nitrite had the best specificity (98.8%) and accuracy (77.4%) while bacteriuria had the best sensitivity (34.5%). Pyuria and LE had the lowest sensitivity (31% and 17.2% respectively). Bacteria isolated from the culture were all gram negative. Escherichia coli was the most prevalent bacteria, represented 44.8% of the positive cases. Amikacin had the best sensitivity among the antibiotics tested. Conclusion: While in theory pyuria and LE might be used in diagnosing UTI, several factors may distort its value. This should be taken into consideration when a child is suspected of having a UTI.

pediatric urinary tract infection, bacteriological profile, accuracy of urinalysis