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Original Article
Online Published: 16 Oct 2025
 


Diagnostic accuracy of urine dipstick testing and urinalysis for pediatric patients with urinary tract infections in the emergency department: a retrospective study from Riyadh, Saudi Arabia

Tahani Alharshan, Maryam Alessa, Amira Nemri, Faisal Alghamdi, Yara Algoraini.


Abstract
Objective:
This study aimed to assess the diagnostic accuracy of the urine dipstick test and urinalysis compared with urine culture in children presenting with suspected urinary tract infections (UTIs) in a tertiary emergency department.
Methods:
This retrospective cohort study included children aged ≤14 years presenting to King Fahad Medical City’s pediatric emergency department between January 2023 and December 2024. The data included demographics, symptoms, urine collection methods, and laboratory results. Results:
Of the 276 patients, urine culture was positive in 23.9%. Leukocyte esterase and nitrite positivity were significantly associated with culture positivity (p<0.001). Leukocyte esterase showed 52.9% sensitivity and 85.5% specificity, whereas nitrite showed 63.6% sensitivity and a 96.2% negative predictive value. Microscopic analysis of white blood cells and bacteria revealed high specificity (93.4% and 89.1%, respectively), but low sensitivity (31% and 28.7%, respectively). A change in urine smell was the only symptom significantly associated with a positive culture (p-value=0.023).
Conclusion:
The dipstick test and urinalysis offer valuable early diagnostic guidance, particularly for detecting nitrite and leukocyte esterase, for ruling out UTIs; however, urine culture remains essential for a definitive diagnosis.

Key words: Pediatric urinary tract infection, urine dipstick, urine culture, diagnostic accuracy, Saudi Arabia


 
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How to Cite this Article
Pubmed Style

Alharshan T, Alessa M, Nemri A, Alghamdi F, Algoraini Y. Diagnostic accuracy of urine dipstick testing and urinalysis for pediatric patients with urinary tract infections in the emergency department: a retrospective study from Riyadh, Saudi Arabia. IJMDC. Online First: 16 Oct, 2025. doi:10.24911/IJMDC.51-1756029623

Web Style

Alharshan T, Alessa M, Nemri A, Alghamdi F, Algoraini Y. Diagnostic accuracy of urine dipstick testing and urinalysis for pediatric patients with urinary tract infections in the emergency department: a retrospective study from Riyadh, Saudi Arabia. https://www.ijmdc.com/?mno=279329 [Access: October 16, 2025]. doi:10.24911/IJMDC.51-1756029623

AMA (American Medical Association) Style

Alharshan T, Alessa M, Nemri A, Alghamdi F, Algoraini Y. Diagnostic accuracy of urine dipstick testing and urinalysis for pediatric patients with urinary tract infections in the emergency department: a retrospective study from Riyadh, Saudi Arabia. IJMDC. Online First: 16 Oct, 2025. doi:10.24911/IJMDC.51-1756029623


Vancouver/ICMJE Style

Alharshan T, Alessa M, Nemri A, Alghamdi F, Algoraini Y. Diagnostic accuracy of urine dipstick testing and urinalysis for pediatric patients with urinary tract infections in the emergency department: a retrospective study from Riyadh, Saudi Arabia. IJMDC, [cited October 16, 2025]; Online First: 16 Oct, 2025. doi:10.24911/IJMDC.51-1756029623


Harvard Style

Alharshan, T., Alessa, . M., Nemri, . A., Alghamdi, . F. & Algoraini, . Y. (2025) Diagnostic accuracy of urine dipstick testing and urinalysis for pediatric patients with urinary tract infections in the emergency department: a retrospective study from Riyadh, Saudi Arabia. IJMDC, Online First: 16 Oct, 2025. doi:10.24911/IJMDC.51-1756029623


Turabian Style

Alharshan, Tahani, Maryam Alessa, Amira Nemri, Faisal Alghamdi, and Yara Algoraini. 2025. Diagnostic accuracy of urine dipstick testing and urinalysis for pediatric patients with urinary tract infections in the emergency department: a retrospective study from Riyadh, Saudi Arabia. International Journal of Medicine in Developing Countries, Online First: 16 Oct, 2025. doi:10.24911/IJMDC.51-1756029623


Chicago Style

Alharshan, Tahani, Maryam Alessa, Amira Nemri, Faisal Alghamdi, and Yara Algoraini. "Diagnostic accuracy of urine dipstick testing and urinalysis for pediatric patients with urinary tract infections in the emergency department: a retrospective study from Riyadh, Saudi Arabia." International Journal of Medicine in Developing Countries Online First: 16 Oct, 2025. doi:10.24911/IJMDC.51-1756029623


MLA (The Modern Language Association) Style

Alharshan, Tahani, Maryam Alessa, Amira Nemri, Faisal Alghamdi, and Yara Algoraini. "Diagnostic accuracy of urine dipstick testing and urinalysis for pediatric patients with urinary tract infections in the emergency department: a retrospective study from Riyadh, Saudi Arabia." International Journal of Medicine in Developing Countries Online First: 16 Oct, 2025. Web. 16 Oct 2025 doi:10.24911/IJMDC.51-1756029623


APA (American Psychological Association) Style

Alharshan, T., Alessa, . M., Nemri, . A., Alghamdi, . F. & Algoraini, . Y. (2025) Diagnostic accuracy of urine dipstick testing and urinalysis for pediatric patients with urinary tract infections in the emergency department: a retrospective study from Riyadh, Saudi Arabia. International Journal of Medicine in Developing Countries, Online First: 16 Oct, 2025. doi:10.24911/IJMDC.51-1756029623




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