Comparison of test characteristics of urine dipstick and urinalysis at various test cutoff points

Lammers, Richard L.; Gibson, Susan I.; Kovacs, Dave; Sears, Wade; Strachan, Gary

doi:10.1067/mem.2001.119427

Cited by 121 publications

(105 citation statements)

References 26 publications

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“…Furthermore, Zaman et al (2010) found leukocyte and bacterial cell NPV to be 78 and 73%, respectively. Whilst it has been proposed that sediment analysis is equivalent to strip analysis (Lammers et al, 2001), Zaman et al (2010) suggested that the sedi-MAX may only be used as a screen for negative samples in conjunction with the dipstick method. However, such a combination of methods defeats the purpose of installing an automated screening method on a local level as it would counteract a potential reduction in workload and cost.…”

Section: Discussionmentioning

confidence: 99%

Screening urine samples for the absence of urinary tract infection using the sediMAX automated microscopy analyser

Sterry-Blunt

Randall

Doughton

et al. 2015

Journal of Medical Microbiology

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Urinalysis culminates in a workload skew within the clinical microbiology laboratory. Routine processing involves screening via manual microscopy or biochemical dipstick measurement, followed by culture for each sample. Despite this, as many as 80 % of specimens are reported as negative; thus, there is vast wastage of resources and time, as well as delayed turnaround time of results as numerous negative cultures fulfil their required incubation time. Automation provides the potential for streamlining sample screening by efficiently (.30 % sample exclusion) and reliably [negative predictive value (NPV) ¢95 %] ruling out those likely to be negative, whilst also reducing resource usage and hands-on time. The present study explored this idea by using the sediMAX automated microscopy urinalysis platform. We prospectively collected and processed 1411 non-selected samples directly after routine laboratory processing. The results from this study showed multiple optimum cut-off values for microscopy. However, although optimum cut-off values permitted rule-out of 40.1 % of specimens, an associated 87.5 % NPV was lower than the acceptable limit of 95 %. Sensitivity and specificity of leukocytes and bacteria in determining urinary tract infection was assessed by receiver operator characteristic curves with area under the curve values found to be 0.697 [95 % confidence interval (CI): 0.665-0.729] and 0.587 (95 % CI: 0.551-0.623), respectively. We suggested that the sediMAX was not suitable for use as a rule-out screen prior to culture and further validation work must be carried out before routine use of the analyser.

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Section: Discussionmentioning

confidence: 99%

Screening urine samples for the absence of urinary tract infection using the sediMAX automated microscopy analyser

Sterry-Blunt

Randall

Doughton

et al. 2015

Journal of Medical Microbiology

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“…Patient report of either vaginal discharge or itching was defined as vaginal symptoms. Due to the reported poor specificity of urinalysis results that are reported as trace positive, [5] urinalysis readings of 1+ and higher were defined as positive tests for urinary leukocyte esterase (leukocytes), protein, and blood, while nitrites were recorded as positive or negative without quantification.…”

Section: Discussionmentioning

confidence: 99%

Urinary Symptoms in Adolescent Females: STI or UTI?

Huppert

Biro

Lan

et al. 2007

Journal of Adolescent Health

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Purpose-To determine if urinary symptoms or urinary tract infections (UTI) were associated with sexually transmitted infections (STI) and which history, clinical, and laboratory findings could distinguish these infections in symptomatic women.Methods-A cross sectional sample of 296 sexually-active females aged 14-22 attending a hospital-based teen health center or emergency department were recruited. Genitourinary symptoms, medical and sexual history, and urinalysis results were recorded. STI was defined as a vaginal swab positive for Trichomonas vaginalis or urine nucleic acid amplification test positive for Neisseria gonorrheae or Chlamydia trachomatis. A urine culture with >10,000 colonies of a single pathogen was considered a positive UTI.Results-In the full sample, prevalence of UTI and STI were 17% and 33%, respectively. Neither urinary symptoms nor UTI was significantly associated with STI. Further analyses are reported for the 154 (51%) with urinary symptoms: Positive urine leukocytes, >1 partner in the last 3 months and history of STI predicted STI. Urinalysis results identified four groups: (1)Normal urinalysis -67% had no infection; (2)Positive nitrites or protein -55% had UTI; (3)Positive leukocytes or blood -62% had STI; and (4)Both nitrites/protein and leukocytes/blood positive -28% had STI and 65% had UTI. Those without a documented UTI were more likely to have trichomoniasis than those with a UTI, and 65% of those with sterile pyuria had STI, mainly trichomoniasis or gonorrhea.Conclusions-Adolescent females with urinary symptoms should be tested for both UTI and STIs. Urinalysis results may be helpful to direct initial therapy.

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“…Patients who had taken antibiotics in the past 72 hours, or had indwelling Foley catheters, symptomatic vaginal discharge, diabetes mellitus, or immunodeficiency disorders were excluded. Specimens containing squamous epithelial cells were not excluded from analysis because other investigators have found that the presence of squamous cells does not affect the diagnostic accuracy of the test (2,3). Urine samples were divided into 3 sterile aliquots, 2 for urinalysis and 1 for urine culture.…”

Section: Collection Of the Specimensmentioning

confidence: 99%

Performance Characteristics of Dipstick and Microscopic Urinalysis for Diagnosis of Urinary Tract Infection

et al. 2010

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Comparison of test characteristics of urine dipstick and urinalysis at various test cutoff points

Cited by 121 publications

References 26 publications

Screening urine samples for the absence of urinary tract infection using the sediMAX automated microscopy analyser

Screening urine samples for the absence of urinary tract infection using the sediMAX automated microscopy analyser

Urinary Symptoms in Adolescent Females: STI or UTI?

Performance Characteristics of Dipstick and Microscopic Urinalysis for Diagnosis of Urinary Tract Infection

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