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Reagent dip-stixs can be used to test for the following chemicals in a fresh
urine sample: - blood
- leukocytes
- protein
- glucose
-
ketones
- nitrite
- N-acetyl-B-glucosaminidase
- bilirubin
-
urobilinogen
Notes: urine-testing strategies for
possible UTI in children 3 years or older (1) - dipstick testing for
leukocyte esterase and nitrite is diagnostically as useful as microscopy and culture,
and can safely be used
- if both leukocyte esterase and nitrite are positive
- the
child should be regarded as having UTI and antibiotic treatment should be started.
If a child has a high or intermediate risk of serious illness and/or a past history
of previous UTI, a urine sample should be sent for culture
- if
leukocyte esterase is negative and nitrite is positive
- antibiotic treatment
should be started if the urine test was carried out on a fresh sample of urine.
A urine sample should be sent for culture. Subsequent management will depend upon
the result of urine culture
- if leukocyte esterase is positive
and nitrite is negative
- a urine sample should be sent for microscopy and
culture. Antibiotic treatment for UTI should not be started unless there is good
clinical evidence of UTI (for example, obvious urinary symptoms). Leukocyte esterase
may be indicative of an infection outside the urinary tract which may need to
be managed differently
- if both leukocyte esterase and nitrite
are negative
- the child should not be regarded as having UTI. Antibiotic
treatment for UTI should not be started, and a urine sample should not be sent
for culture. Other causes of illness should be explored
Reference: - NICE
(August 2007).Urinary tract infection in children: diagnosis, treatment and long-term
management .
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