Leucocituria y tinción de gram para el diagnóstico de infección urinaria
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Rev. bol. ped.
Abstract
Objetivo: disponer de métodos microscópicos rápidos para el diagnóstico y demostrar la validez y efectividad de estas pruebas para certificar una infección urinaria. Material y métodos: se estudiaron 719 muestras de orina de niños del Hospital Albina Patiño y del Hospital Materno Infantil Germán Urquidi, en niños con sospecha de infección urinaria (IU) y niños controles con antecedentes de IU. Las edades comprendían de 2 meses a 5 años, las muestras se obtuvieron, por bolsa de plástico, media micción, sondaje vesical y punción suprapúbica. A cada muestra se practicó recuento leucocitario y tinción de Gram que se compararon con urocultivos respectivos. Resultados: 719 muestras de orina estudiadas, 233 fueron de niños, 486 de niñas. La recolección fue por bolsa en el 49.3%, media micción en el 34.9%, sondaje vesical en el 8,4% y punción suprapúbica en el 7.2%. Del total de muestras estudiadas 197 desarrollaron más de 100.000 UFC/ml, en 448 no hubo crecimiento bacteriano. En las muestras con cultivo positivo, el 76.6% presentó leucocituria y 95.4% la tinción de Gram fue positiva. En orinas con cultivo negativo encontramos leucocituria en el 13.7% y la tinción de Gram positiva en 2.8%. De todo esto la leucocituria nos da una sensibilidad del 69% y especificidad del 90%, la tinción de Gram la sensibilidad 93% y especificidad 98% respectivamente. Conclusiones: este análisis potenciado proporciona una sensibilidad alta con un valor predictivo positivo alto que ayudaría al diagnostico rápido y economico de una infección urinaria.
Objective: available methods based on microscopic studies for a quick, economic diagnosis and to demonstrate the validity and effectiveness of these tests, to certify a urinary infection. Material and methods: 719 urine samples of the Albina Patiño Hospital and Germán Urquidi Maternal Infantile Hospital were studied, in children with suspicion of urinary infection and in children with history of urinary infection. Patients range from 2 months to 5 years of age, samples were obtained by gathering in plastic bag collector, half micturition, bladder catheter and suprapubic punction. To every sample was performed leukocyte count, Gram stain and they were compared with their respective cultures. Results: 709 samples, 233 were boys, 486 girls. The sample gathering from collector bag 49.3%, half micturition 34.9%, bladder catheter 8.4% and suprapubic puncture 7.2%. Of the total of samples studied 197 developed more than 100.000 UFC/ ml, in 488 there was no bacterial growth. In the samples with positive culture, 76.6% presented leukocytes in urine, 95.4% gave positive Gram stain. In negative cultures we found 13.7% leukocytes in urine and positive Gram stain in 2.8%. The in-crease of leukocytes in urine gives us a sensibility of 69% and specifi city of 90%. The Gram stain sensibility is 93% and specificity of 98% respectively. Conclusions: this potentiated analysis provides a high sensibility with high positive predictive value that would help to diagnose quickly and cheaply urinary infections.
Objective: available methods based on microscopic studies for a quick, economic diagnosis and to demonstrate the validity and effectiveness of these tests, to certify a urinary infection. Material and methods: 719 urine samples of the Albina Patiño Hospital and Germán Urquidi Maternal Infantile Hospital were studied, in children with suspicion of urinary infection and in children with history of urinary infection. Patients range from 2 months to 5 years of age, samples were obtained by gathering in plastic bag collector, half micturition, bladder catheter and suprapubic punction. To every sample was performed leukocyte count, Gram stain and they were compared with their respective cultures. Results: 709 samples, 233 were boys, 486 girls. The sample gathering from collector bag 49.3%, half micturition 34.9%, bladder catheter 8.4% and suprapubic puncture 7.2%. Of the total of samples studied 197 developed more than 100.000 UFC/ ml, in 488 there was no bacterial growth. In the samples with positive culture, 76.6% presented leukocytes in urine, 95.4% gave positive Gram stain. In negative cultures we found 13.7% leukocytes in urine and positive Gram stain in 2.8%. The in-crease of leukocytes in urine gives us a sensibility of 69% and specifi city of 90%. The Gram stain sensibility is 93% and specificity of 98% respectively. Conclusions: this potentiated analysis provides a high sensibility with high positive predictive value that would help to diagnose quickly and cheaply urinary infections.
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Vol. 47, No. 2