Abstract Ref Number = APCP279
A DIAGNOSTIC STUDY OF URINE GRAM STAINING FOR URINARY TRACT INFECTIONS IN YOUNG CHILDREN AGED 2 MONTHS – 2 YEARS
Riki Alkamdani,Partini Pudjiastuti Trihono,Aryono Hendarto,Dalima AW Astrawinata
Background : Urinary tract infection (UTI) is one of the commonest diseases in young children age 2 months - 2 years. It is often difficult to diagnose in children because of the atypical symptoms. Urine culture as definitive diagnosis modality needs lengthy time to show results, while urinalysis sometimes can not show UTI signs due to rapid bladder emptying. Urine Gram staining is a fast, easy, and cheap modality that might be used for early diagnosis of UTI in children.
Material : A diagnostic study with cross-sectional design was conducted at Cipto Mangunkusumo Hospital from May to December 2016. The study involved 59 clinically suspected UTI children aged 2 months - 2 years selected by consecutive sampling method. Urine sample was taken by urethral catheterization technique. They were sent for Gram staining, urinalysis, and urine culture. Urine culture result as the gold standard was expressed as UTI when colonies of bacterial growth >50,000 cfu/mL. Gram stain results were considered positive if any type of bacteria was found per high-power field.
Results : The prevalence of UTI in this study was 38.9%. The sensitivity of urine Gram staining was 47.8% (95% CI 26.8 to 69.4%), specificity of 97.2% (95% CI 85.5 to 99.9%), positive predictive value of 91.7% (CI 95 % from 60.3 to 98.8%), negative predictive value of 74.5% (95% CI 60.3 to 98.8%), positive likelihood ratio of 17.2 (95% CI 2.4 to 124.6), negative likelihood ratio of 0.54 (95% CI 0.36 to 0.8), and accuracy of 78%.
Conclusions : There is a correlation between urine Gram staining and urine culture in the diagnosis of UTI in children aged 2 months-2 years. Antibiotics should be administered immediately after urine Gram staining shows positive result. If clinical symptoms of UTI is not very distinctive and urine Gram staining shows negative result, antibiotics should be delayed until urine culture shows result.
Keywords: Urinary tract infections Gram staining Diagnostic test Young children