The relationship between full urine examination and urine culture findings for 3-6 years old children applied to Adnan Menderes University (ADU) pediatric emergency clinic

Introduction and aims: Among childhood infections, Urinary Tract Infection (UTI) is the second most common type of infection after respiratory tract infection. Especially in childhood, UTI renal scarring can cause complications such as end-stage renal failure, hypertension. Early diagnosis and treatment of the disease is important for prevention of these complications. The gold standard for the diagnosis of UTI is the production of the causative pathogen in the urine culture. However, the fact that urine culture is very limited especially in primary health care institutions, taking the time to complete urine cultures requires evaluating the patient with different examinations. For this purpose, Full Urine Examination (FUE) and urine microscopy can be a guide for physicians. We aimed to reveal the place of FUE parameters leukocyte esterase (LE) in the UTI diagnosis of pyuria, hematuria and bacteriuria, which can be detected with urine microscopy and the contribution of the association of these tests with symptoms to the diagnostic process. Materials and methods: A total of 728 patient, aged between 3 and 6 years who were admitted to the Adnan Menderes University Practice and Research Hospital Pediatric Emergency Polyclinic between 01.01.2016 and 31.12.2016 and who were able to give both urine and urine cultures were included in the study. The files of the patients were scanned backwards from the MiaMedR Hospital Information Management System software, data were recorded and evaluated with the SPSS 18.0 Statistical Package Program. Frequency analyzes of the data were performed, which were evaluated by square test and Logistic regression analysis, p <0,.05 was considered significant. Findings: 425 (58,.4%) female and 303 (41.,6%) male patients were included in the study. 70,269.5% of the patients with urine culture was female, and 29,830.5% of them was male. Rate of incidence of contamination in urine cultures was 2,.33%. The most common symptom of the patients in the study was fever with a rate of 41,.6%. Two symptoms with a high likelihood of UTI detection were dysuria with a rate of 13.,6% of the patients and color and odor change with a rate of 8,.2% of the patients. All of the FUE parameters were statistically significant in relation to urine culture (p <0,.01). Sensitivities of LE, nitrite, leucocyte, erythrocyte and bacterial infection in the detection of urinary tract infection in FUE were calculated as 63,.1%; 21%; 59%; 34,.7%;% respectively and specificity was calculated as 78,.4%; 99,.6%; 81,.3%; 85,.8%; 99,.8% respectively. In the logistic regression analysis including only symptoms it was seen that the presence of the dysuria increased the likelihood of UTI by 3,15 times and when the FUE parameters were evaluated it was found that the presence of leucocyte in the urine increased the probability of UTI by 2,.52 times, the presence of nitrite increased by 19,76 times and the presence of bacteria increased by 13,43 times. Conclusion: In the presence of symptoms at the urinary tract infections, FUE and urine microscopy provide guidance. LE and leukocyte negativity are more effective in recognizing exclusion, while nitrite and bacterial positivity are helpful in supporting recognition. In order to be more informed on this subject, we need both adult and pediatric populations and community based other studies. Key words: Urinary tract infection, complete urine screening, leukocyte esterase, nitrite