Disappointing dipstick screening for urinary tract infection in hospital inpatients.

Author:

Zaman Z,Borremans A,Verhaegen J,Verbist L,Blanckaert N

Abstract

AIM: To compare the performance of leucocyte esterase and nitrite dipstick tests with microscopic examination and culture of first morning urines (n = 420) of hospital inpatients. RESULTS: The sensitivity, specificity, and negative predictive value of the leucocyte esterase test for the cutoff of > 10 WBC/microliter were 57%, 94%, and 68%, respectively. For > 5 WBC per high power field (HPF) these variables were 84%, 90%, and 93%. For > 10(5) colony counts/ml, the sensitivity of the nitrite test was 27%, specificity 94%, and negative predictive value 87%. When either leucocyte esterase or nitrite positivity was accepted as a marker of urinary tract infection, the sensitivity was 78%, specificity 75%, and negative predictive value 94%, and there were 22% false negative results. Semiquantitative microscopic estimation of bacteria per HPF yielded 40% false positives. CONCLUSIONS: Leucocyte esterase and nitrite dipstick tests are not suitable for screening for urinary tract infections.

Publisher

BMJ

Reference5 articles.

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3. Reliability of a urine dipstick in emergency department patients;Propp, D.A.; Weber, D.; Ciesla, M.L.;Ann Emerg Med,1989

4. A dipstick test of urinary tract infections;Molyneux, E.M.; Robson, W.J.;J Accid Emerg Med,1995

5. Use of dipsticks for routine analysis of urine from children with acute abdominal pain;Woodward, M.N.; GriYths, D.M.;BMJ,1993

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