Detection of Bacteriuria by Leukocyte Esterase, Nitrite, and the Automicrobic System

Bartlett, Raymond C.; O’Neill, Dennis; McLaughlin, James C.

doi:10.1093/ajcp/82.6.683

Cited by 22 publications

(20 citation statements)

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“…The prevalence of infection in the elderly population ranges from 5 to 20% in men to 10 to 20% in women (100). Elderly patients with obstruction, poor bladder emptying, dementia, stroke, diabetes mellitus, and cardiovascular diseases are more likely to have bacteriuria than patients in the same age group without these abnormalities (100).…”

Section: :1mentioning

confidence: 99%

“…On the other hand, the most sensitive method (98%) for detecting i105 CFU/ml was the microscopic examination of stained centrifuged urine. However, this procedure is tedious and time-consuming because it requires centrifugation of 10 ml of urine for 5 (30). However, the specificity for each of the dipstick tests was 98%.…”

Section: Laboratory Analysesmentioning

confidence: 99%

“…Some investigators have demonstrated a cost savings by using the Chemstrip LN to determine the need for culturing urine specimens (5,49,56). With this approach, Marsik and associates evaluated urine specimens from pediatric and adolescent patients and estimated a $5,000/year savings to the laboratory and a $10,000/year savings to the patient (56).…”

Section: Laboratory Approach To Screeningmentioning

confidence: 99%

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Detection of urinary tract infections by rapid methods

Pezzlo

1988

Clin Microbiol Rev

121

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A review of rapid urine screens for detection of bacteriuria and pyuria demonstrates a number of available alternatives to the culture method. Selection of one or more of these systems for routine use is dependent upon the laboratory and the patient population being tested. The laboratory approach to the diagnosis of urinary tract infection should consider the clinical diagnosis of the patient whenever possible. Keeping in mind that quantitative urine cultures alone cannot be used to detect infection in some patient populations unless lower colony counts are considered, a rapid screen may be a more practical approach. It has become accepted that 10(5) CFU/ml can no longer be used as the standard for all patient groups, that pyuria often is important in making the diagnosis of a urinary tract infection, and that most of the rapid screens are more sensitive than the culture method at 10(5) CFU/ml. Presently, no one approach can be recommended for all laboratories and all patient groups. However, each diagnostic laboratory should select one approach which is best for its situation. It is not practical, efficient, or cost effective to define a protocol for each possible clinical condition; however, all should be considered when developing a protocol. This protocol should be compatible with the patient population and communicated to the physicians. Use of a rapid screen should be beneficial to the patient, the physician, and the laboratory.

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Section: :1mentioning

confidence: 99%

Section: Laboratory Analysesmentioning

confidence: 99%

Section: Laboratory Approach To Screeningmentioning

confidence: 99%

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Detection of urinary tract infections by rapid methods

Pezzlo

1988

Clin Microbiol Rev

121

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“…Many screening methods have been proposed to detect bacteria in urine on the day of collection, both to shorten the delay inherent in the culture system and to decrease the time spent in the laboratory separating negative specimens from those considered to have significant bacteriuria. These screening tests include several manual (4,5,8,13,15,18), semiautomated (10,11,14), and automated systems (7,9,10,17).…”

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confidence: 99%

Laboratory evaluation of leukocyte esterase and nitrite tests for the detection of bacteriuria

Pfaller¹,

Koontz²

1985

J Clin Microbiol

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We compared the sensitivity, specificity, and predictive values of the 1-min leukocyte esterase test and the test for urinary nitrite alone and in combination as screening tests for bacteriuria in over 5,000 clinical urine specimens. The leukocyte esterase-nitrite combination had a sensitivity of 79.2%, a specificity of 81%, and a negative predictive value of a negative test of 94.5% for specimens with 2105 CFU/ml. Although the sensitivity of this test was too low to allow its use as the only screening test for bacteriuria, it may serve as a useful adjunct to culturing and other urine-processing systems in the microbiology laboratory.

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“…We set 5 × 10 4 CFU/mL as the discriminator value because it has been reported 8 that the strips can reliably detect fewer than 10 4 CFU/mL. Bartlett et al 9 have shown that there is a significant decrease in negative predictive value at less than 10 4 CFU/mL, and although Kass recommends 10 5 CFU/mL in a normal population, our population was not normal, but had a relatively high incidence of urinary tract infections. We felt that we could not ignore any culture greater than 5 × 10 4 CFU/mL.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Chemstrip LN® in a Male Geriatric Population

Gelbart

Prabhudesai

1988

J American Geriatrics Society

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A dipstick method for bacteriologic screening of urine using a combination of leukocyte esterase and nitrite indicators, Chemstrip LN, was evaluated in a male inpatient geriatric population. Three hundred seventy-five urine samples from 198 symptomatic patients (age range, 45 to 98 years; mean, 69.6) were tested by LN and cultured using standard methods. LN showed 169 negatives, but in 7 of these cases, the culture was positive (greater than or equal to 5 X 10(4) col/mL). Organisms recovered from these cultures were Candida (not albicans), Group B Streptococcus, Staphylococcus aureus, and in four cases, Pseudomonas aeruginosa. In the four cases of missed Pseudomonas the patients were receiving aminoglycoside therapy for 2 to 6 days and/or drugs that dye the urine. Despite the fact that many patients were on medications known to interfere with the test strips, the negative predictive value was still 96.0% showing that the strips may be suitable for use with this population given the understanding that certain antibiotics and/or substances that dye the urine may give false negative results.

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Detection of Bacteriuria by Leukocyte Esterase, Nitrite, and the Automicrobic System

Cited by 22 publications

References 0 publications

Detection of urinary tract infections by rapid methods

Detection of urinary tract infections by rapid methods

Laboratory evaluation of leukocyte esterase and nitrite tests for the detection of bacteriuria

Evaluation of Chemstrip LN® in a Male Geriatric Population

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