Background: Urinary tract infections (UTIs) are among the most common bacterial infections in children. Because they are often not diagnosed early, UTIs can lead to complications such as renal scarring and chronic kidney disease. For diagnosis urine culture is the gold standard test, rapid screening tools are there for early diagnosis and management.

Methods: This prospective observational study was conducted in a tertiary care hospital between January 2021 and June 2022. This study included 217 children who met inclusion criteria and they are suspected of having a UTI. All patients had urine dipstick testing for nitrites and leukocyte esterase (LE), along with urine culture and microscopy.

Results: Urine culture was positive in 17.5% of the uti cases, Escherichia coli and Acinetobacter baumannii are the most common organisms detected. Microscopy suggested highest sensitivity at 93.5% and a negative predictive value of 98.3%, which indicates strong rule-out potential. LE showed moderate sensitivity at 80.6% but lower specificity at 61.3%.Nitrite testing had excellent specificity at 94.6% and a positive predictive value of 74.2%. LE and nitrite testing both combined, improved specificity to 97.9% and PPV to 86.4%.

Conclusion: Most reliable screening test for ruling out pediatric UTI was found to be Urine microscopy, while nitrite testing had good rule-in accuracy. Combination of dipstick results improves specificity for diagnosis. Hence in settings with limited resources they are useful due to a quickness and cost-effective alternative to culture. 

KEYWORDS: Routine Urine Microscopy ,Urinary Tract Infection, Leukocyte Esterase Test, Nitrite Test, Dipstick Test.