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Register a new usersensitivity and specificity of nitrite test to urine culture for diagnosing urinary tract infection in patients with sickle cell anemia
اختبار حساسية و نوعية فحص النتريت مقابل زرع البول لتشخيص الإنتانات البولية لدى مرضى فقر الدم المنجلي
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Tishreen University ورقة بحثية
Publication date
2018
fields
Medicine
and research's language is
العربية
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Shamra Editor
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هدف الدراسة: تحديد حساسية و نوعية اختبار النتريت في تشخيص إنتانات الطرق البولية لدى الأطفال المصابين بفقر الدم المنجلي و لديهم أعراض بولية بالمقارنة مع المعيار الذهبي للتشخيص و هو زرع البول. طريقة البحث و المرضى: شملت عينة الدراسة 79طفلاَ ممن تراوحت أعمارهم بين (2-14) سنة و المصابين بفقر دم منجلي و لديهم أحد الأعراض (ترفع حروري>38°،ألم بطني ،إلحاحية بولية، صعوبة بالتبول، تعدد بيلات) من مراجعي عيادة الأطفال العامة و قسم إسعاف الأطفال في مشفى تشرين الجامعي في اللاذقية ما بين عامي (2016-2017) . تم أخذ عينة منتصف التبول و إجراء فحص البول لتحري اختبار النتريت مع اجراء الزرع و التحسس الجرثومي. النتائج: لوحظ وجود بيلة جرثومية لدى 17 طفل مريض لديه فقر دم منجلي أي بنسبة 21,5%. كان اختبار النتريت إيجابي لدى 12 من أصل 17طفل مريض أي بنسبة 70,5%. نوعية اختبار النتريت مقابل الزرع الجرثومي كانت 95,2% أما الحساسية 70,6% و القيمة التنبؤية الإيجابية 80% و القيمة التنبؤية السلبية 92%. إيجابية اختبار النتريت مرتبط مع البيلة الجرثومية أما سلبيته مرتبط مع غيابها و بالتالي اختبار النتريت مفيد في المسح عن الإنتان البولي لدى الأطفال المصابين بفقر دم منجلي و لديهم أعراض بولية.
Objective: Evaluate sensitivity and specificity of nitrite test to urine culture(gold standard) for diagnosing urinary tract infection in patients with sickle cell anemia with urinary symptoms and signs. Methods: The study sample included 79 children aged 2 to 14 years with SCA presenting with fever (temperature >38°C),abdominal pain, urgency, dysuria or increased urinary frequency who referral to the general pediatric clinic and the children's ambulance department in Tishreen University Hospital in Lattakia during( 2016-2017). Midstream urine specimen was collected from children. Samples were subjected to nitrite test, culture and sensitivity. Results : There was significant bacteriuria in 17 (21.5%) children with SCA. A positive test for nitrite was obtained in 12 of the 17(70.5%) children. The nitrite test has a specificity of 95.2% in detecting bacteriuria, a sensitivity of 70.6%, a positive predictive value of 80% and a negative predictive value of 92%. A positive nitrite test was significantly associated with bacteriuria, while a negative test was also significantly associated with an absence of bacteriuria.
References used
ASINOBI AO, FATUNDE OJ, BROWN BJ, OSINUSI KA, PASINA NA .Urinary tract infection in febrile children with sickle cell anaemia in Ibadan, Nigeria. Ann Trop Paediatr 23(2): 2003;129 -34
BROWN BJ, ASINOBI AO, FATUNDE OJ,OSINUSI K, FASINA NA. Evaluation of the nitrite test in screening for urinary tract infection in febrile children with sickle cell anemia. Nig J Paediatr 31: 2004;10-13
SARA NAJEEB, TEHMINA MUNIR, SABAHAT REHMAN, AMIRA HAFIZ, MEHREEN GILANI AND MEHWISH LATIF. Comparison of Urine Dipstick Test with Conventional Urine Culture in Diagnosis of Urinary Tract Infection. Journal of the College of Physicians and Surgeons Pakistan Vol. 25 (2): 2015, 108-110
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The majority of patients with SCD receive transfusions at some point in their
life. Transfusion can be simple transfusion or exchange transfusions which offer better control of blood
volume and viscosity. Such transfusions are most readily accompli
shed via automated red cell exchange.
Evaluate the results of our experience in applying the technique of selective cell separation by continuous
flow (Cytapheresis) for automated red cell exchange for patients with sickle cell anemia to reduce the level
of hemoglobin S (HbS) in certain cases, especially in preparation for major surgery.
This study aims to show the effectiveness of hydroxyl urea in the treatment of
severe forms of sickle-cell anemia.
The study included 30 patients from patients with sickle cell anemia and who
reviewed the Blood clinics in AL- Assad University Hosp
ital .
We had studied patients treated with hydroxy urea for at least 6 months, where it was
compared to blood and clinical variables before and after hydroxy urea treatment.
The results showed an improvement in blood and clinical manifestations , and it was
noted a significant increase in the level of fetal hemoglobin, and a decrease in the level of
hemoglobin and sickle cell after hydroxy urea treatment.
hydroxy urea treatment also led to a clear increase in the level of total hemoglobin,
and a decrease in the value of total bilirubin.
Decrease in the number of the pain episodes that needed hospitalization, and the
number of times of blood transfusion after treatment, too.
Bacterial pathogens associated with urinary tract infection were
studied. The study examined 120 urine samples taken from the middle
of the urinary flow of patients with symptoms of urinary tract infection.
Back pound: Patients with end stage renal disease (ESRD) and lower urinary tract anomalies (LUTA) are often considered high risk for renal transplantation.
Methods and subjects: To evaluate the degree of risk, we have reviewed our experience of 17 p
atients with (ESRD) and (LUTA). The study was carried out in Almoussat university hospital, between 5/ 2003 and 5/2009. After a detailed urological assessment, the patients had been undergone either non-continent cutaneous diversion (Bricker) (Two patients) or continent cutaneous diversion with bladder augmentation (14 patients), before renal transplantation.
Results: The patient and graft survival rates were 84.62% and 100%, respectively. The presence of an ileal conduit did not adversely affect graft survival. And the commonest complication was persistent urinary tract infection, which occurred in all patients (100%), but didn’t cause any graft loss. However two patients died because of systemic infections and their graft function was
good.
Conclusion: Renal transplantation is a satisfactory option for patients with ESRD due to LUTA, but it is important to carry out detailed urological assessment prior to the transplant procedure.
Ninety urin samples were taken from patients suffering from
urinary tract infection .the purpose was to isolate and identify Ecoli.
After cultural and biochemical diagnosis,[47] isolates had been
obtained with [63.5%] for E-coli out of [74] samples that had
bacterial growth.
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