Use of Urinary Gram Stain for Detection of Urinary Tract Infection in Childhood

Abstract

In this study, 100 children with symptoms suggesting urinary tract infection were given a urine culture, a urine Gram stain, and four urinalysis tests: leukocyte esterase, nitrite, microscopy for bacteria, and microscopy for pyuria. Our goal was to compare the validity of the urine Gram stain to a combination of pyuria with Gram stain and overall urinalysis (nitrite positivity, leukocyte esterase positivity, bacteria microscopy, or white blood cell microscopy) A positive urine culture was found in 70 (70%) of 100 children aged two to fifteen years: 40 females (57%) and 30 boys (43 percent). The most commonly isolated agent was Escherichia coli. The urine Gram stain had a sensitivity and specificity of 80% and 83 percent, respectively, while the combination of pyuria with Gram stain had a sensitivity and specificity of 42 percent and 90 percent, and the overall urinalysis had a sensitivity and specificity of 74 percent and 3.5 percent. In symptomatic children, neither type of urine screening should be used instead of a urine culture, according to our findings.