Urethral Discharge as A Novel Manifestation of Urinary Tract Infection in Children ≤24 Months Old

Background: Children with urinary tract infections (UTIs) are prone to kidney scarring if they are not treated promptly; however, ambiguous symptoms before fever onset makes the early detection of UTIs difficult. Our study aimed to identify urethral discharge as an early manifestation in children with UTI. Methods: This study enrolled 678 children younger than 24 months with paired urinalysis and culture performed between 2015 and 2021; 544 children were diagnosed with UTIs. Clinical symptoms, urinalysis, and paired urine culture results were compared. Results: Urethral discharge was observed in 5.1% of children with UTI and yielded a specificity of 92.5% for diagnosing UTI. Children with urethral discharge had a less severe UTI course, furthermore, nine of them received antibiotics before fever occurred and seven of them were free of fever during UTI course. Urethral discharge was associated with alkalotic urine and Klebsiella pneumonia infection.Conclusions: Urethral discharge is an early symptom in children with UTI; it may present before fever onset and help ensure prompt antibiotic intervention.Trial registration: Not applicable.

Diagnostic Accuracy of Urine Analysis (DR) in Suspicious Cases of Urinary Tract Infections by Taking Urine Culture as Gold Standard

Background: Urinary tract infections (UTI) are one of common clinical condition encountered in various clinical settings. This the most common infection, typically diagnosed on the basis history and clinical examination endorsed by urine analysis and culture sensitivity. Timely diagnosis and treatment are crucial in management. For diagnosis of UTI, Urine culture is standard, as it provide detail information for urinary pathogens, but it has certain disadvantages e.g. urine culture is costly, takes longer time, and up to 60-80% of the results are negative. Objective: To determine the diagnostic accuracy of urinalysis (Urine DR) in detection of urinary tract infection (UTI) among suspected cases of UTI by taking urine culture as gold standard. Materials And Methods: This cross sectional study was conducted at study was conducted at Department of Urology, Jinnah Postgraduate Medical Centre (JPMC) Karachi, from march 2021 to September 2021. All patients who visited to JPMC Karachi and fulfilled the inclusion criteria and were included in the study after getting Informed consent. All patients were evaluated by urinalysis and urine culture. The results of urinalyses were recorded and compared with the results obtained on subsequent urine cultures. All of the specimens were obtained by the “clean-catch” method. All data and results were recorded on proforma and used electronically for research purpose. Results: Mean ± SD of age was 52.6±8.5 years. In distribution of gender, 60 (53.1%) patients were male while 53 (46.9%) were female patients. Diagnostic accuracy of urinalysis was 73.45% in diagnosis of urinary tract infection with sensitivity 76.47%, specificity 72.15% PPV 54.17% and NPV was found to be 87.69% by using urine culture findings as gold standard. Conclusion: It is to be concluded that evaluating of urinary tract infection (UTI) with urinalysis (Urine DR) did not prove helpful and comparable to urine culture. Urine culture should be done in each and every suspected case of UTI. Keywords: Bacteriuria, Diagnostic Accuracy, Sensitivity, Specificity, Urinalysis

UJI DIAGNOSTIK UJI DIAGNOSTIK PEMERIKSAAN NITRIT DENGAN KULTUR URIN PADA SUSPEK INFEKSI SALURAN KEMIH

Urinary tract infection (UTI) is the second largest infection after respiratory infection and can cause sepsis. Urinary tract infections occur due to the entry of microorganisms in the urinary tract. The urinary tract that is usually infected is the urethra (urethritis), bladder (cystisis), ureter (ureteristis), kidney tissue (pyelonephritis). This study aims to determine the sensitivity and specificity of the diagnostic test of nitrite examination with urine culture in suspected urinary tract infections. The method of this study is a descriptive-analytical study with a cross-sectional retrospective approach, conducted in the STIKes field laboratory with the population studied in this study were all patients diagnosed with urinary tract infection with a sample size of 50 samples. The results of this study showed positive nitrite results as many as 17 people, 34% percentage, and negative nitrite results as many as 33 people with a percentage of 66% and on urine culture examination obtained positive results as many as 17 people with a percentage of 34%, which results in growth of bacterial colonies on cultures> 100,000 CFU / mL and negative results of 33 people with a percentage of 66%. Sensitivity Results 82%, Specificity 90.9%. The conclusion of this study is the value of sensitivity, high specificity so that the nitrite test with urine culture can be applied to help diagnose UTI.

Comparison of Urine Flow Cytometry on the UF-1000i System and Urine Culture of Urine Samples from Urological Patients

<b><i>Introduction:</i></b> The aims of this study were to evaluate urine flow cytometry (UFC) as a tool to screen urine samples of urological patients for bacteriuria and to compare UFC and dipstick analysis with urine culture in a patient cohort at a urological department of a university hospital. <b><i>Methods and Material:</i></b> We screened 662 urine samples from urological patients (75.2% male; 80.7% inpatients; mean age 58 years). UFC results were compared to microbiological urine culture. <b><i>Results:</i></b> The accuracy in using the UFC-based parameters for detecting cultural bacteriuria was 91.99% and 88.97% for ≥10⁵ colony-forming units (CFU)/mL and ≥10⁴ CFU/mL, respectively. UFC and leukocyte dipstick analysis measured leukocyturia similarly (Pearson correlation coefficient 0.87, <i>p</i> value &#x3c;0.01%), but dipstick analysis scored less accurately on bacteriuria (accuracy 59.37% and 62.69%). UFC remained effective in subgroup analysis of patients of both sexes and with different urological conditions with its overall use only slightly impaired when assessing gross hematuria (NPV 84.62% for ≥10⁴ CFU/mL). UFC also reliably removed those urine samples below cutoffs with negative predictive values of 99.28% for ≥10⁵ CFU/mL and 95.86% for ≥10⁴ CFU/mL. <b><i>Conclusion:</i></b> Counting bacteria with UFC is an accurate and rapid method to determine significant bacteriuria in urological patients and is superior to dipstick analysis or indirect surrogate parameters such as leukocyturia. When UFC is available, we recommend it to be used for the diagnosis of bacteriuria over findings obtained by dipstick analysis.

Performance of Conventional Urine Culture Compared to 16S rRNA Gene Amplicon Sequencing in Children with Suspected Urinary Tract Infection

Concordance between conventional culture and 16S rRNA gene amplicon sequencing appears to be high. In children with equivocal culture results, 16S rRNA gene results may provide information that may help clarify the diagnosis.

Incidence of Asymptomatic Bacteriuria in Pregnant Women

Background: Asymptomatic bacteriuria is the presence of bacteria in the properly collected urine of a patient that has no signs and symptoms of urinary tract infection. Aim: This study was carried out to determine the incidence of asymptomatic bacteriuria in pregnant women in Saveetha medical college, Thandalam, Tamil Nadu. Materials and Methods: A total of 250 pregnant women attending antenatal clinic at civil hospital, Saveetha medical college, over a period of 3 months, with age groups between 18 to 30 years agreed to enter the study and were clinically evaluated. All these women were asked to submit clean catch midstream urine samples and it was examined under the microscope and by culture method. Results: A total of 250 pregnant women included in our study, with varying age groups between 18 to 30 years and the highest incidence was seen in between the 26 to 30 age group. Asymptomatic bacteriuria was seen in 27.2% of the pregnant women. The prevalence of Escherichia coli was among the most dominant organism, followed by Staphylococcus aureus ,klebsiella and proteus species. Conclusion: The study showed 27.2% of the pregnant women to have asymptomatic bacteriuria. This can be reduced by screening the mothers in first trimester and routine urine culture test must be carried out.

Prevalence of urinary tract infection in febrile children of less than five years of age

To determine the prevalence of urinary tract infection in febrile children, less than 5 years of age. To assess the validity of microscopic urine analysis and urine culture in the diagnosis of urinary tract infection.Prospective study. Children attending the department of paediatrics, Dr.V.R.K. Women’s Medical College, Teaching Hospital & Research Centre, with febrile illness during June 2019-June 2020.370 children between 1 month to 5 years of age.Data related to age, sex, nutritional status, socioeconomic status and predisposing risk factors like urethral instrumentation, bowel habits etc, were noted. A thorough physical examination with relevant investigations were carried out in all these patients. Routine urinary microscopy was done in all patients and urine culture was done in those who showed pyuria of &#62;5 pus cells/HPF in centrifuged urine sample.In our study, overall prevalence of UTI was 3.5% in children between 1 month to 5 yrs and 4.1% in children &#60;2yrs and 7% in Children &#60;1 year of age with M:F ratio of 1:1in children &#60;2yrs. Prevalence of culture positivity was 44% in those who showed &#62;10 pus cells/HPF in centrifuged sample of urine and 2.5% in those who showed &#62;5pus cells/HPF.The presence of obvious source of fever such as upper respiratory tract infection or otitis media is not reliable in excluding urinary tract infection. Overall prevalence of UTI in our study was low (3.5%) and prevalence among children &#60;2yrs was 4.1% and &#60;1 year of age was 7%. Pyuria of &#62;5pus cells/HPF (centrifuged urine sample) should be considered as significant and further evaluation should be done to initiate prompt treatment.