Detection of pyuria and bacteriuria in symptomatic ambulatory women

Blum, Raymond N.; Wright, Richard

doi:10.1007/bf02598002

Cited by 34 publications

(25 citation statements)

References 22 publications

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“…This implies that to use significant pyuria to diagnose or predict bacteriuria in children with SCA will result in significantly large numbers of false-positive and falsenegative results. The high sensitivity obtained in this study is comparable to that of Smith et al 10 as well as Blum et al 13 who reported sensitivities of significant pyuria to be 64% and 98% among subjects with significant bacteriuria. The specificity in our study was low in contrast with specificity of 68% reported by Blum et al 13 The use of symptomatic women as their sample population for the study may contribute to the observed significant difference.…”

Section: Discussionsupporting

confidence: 89%

“…However, the absence of pyuria in children with UTI is rare but can occur when a child is been evaluated so early in the course of the infection when the inflammatory response has not yet developed. 13 Many workers, on the contrary, reported low sensitivity of pyuria among children with UTI. 7,14 The higher sensitivity reported in this study as compared to the 55.4% reported by Mava et al 7 may be due to the fact that most of the SCA children with bacteriuria in this study were in SCA crises which could have been precipitated by UTI.…”

Section: Discussionmentioning

confidence: 99%

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Pyuria as a diagnostic test for urinary tract infection in children with sickle cell anaemia in Zaria, Nigeria

Yauba¹,

Aikhionbare²,

Ogunrinde³

et al. 2014

Nig. J. Paed.

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Abstract:Objective: This study aimed at determining the significance of pyuria as a screening test for UTI in children with sickle cell anaemia (SCA). Methods: Two hundred and seventy-two children with SCA, aged 6 months to 15 years, were studied out of which 185 (68.0%) were in stable state and 87 (32.0%) were in crises. Their urine was assessed for microscopy culture and sensitivity. Significant pyuria and bacteriuria was determined using standard methods. Results: Significant bacteriuria was detected in 22 (8.1%) of the 272 subjects with SCA. The prevalence of significant bacteriuria was higher among those in crisis (18/87; 20.7%) than in those in steady state (4/185; 2.2%) and the difference was statistically significant (χ 2 = 27.323, p = 0.001). Of the 22 SCA subjects with confirmed UTI, 19 (86.4%) had significant pyuria with a sensitivity of 86.4%, specificity of 68.8%, and positive predictive value of 19.6%. The most common bacterial isolates were Escherichia coli 11 (50.0%) while the least isolated were Salmonella typhi 1 (4.6%). Conclusion: This study indicates that pyuria as a screening test for UTI is not very specific but very sensitive necessitating a more test to be done for diagnosis of UTI.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Pyuria as a diagnostic test for urinary tract infection in children with sickle cell anaemia in Zaria, Nigeria

Yauba¹,

Aikhionbare²,

Ogunrinde³

et al. 2014

Nig. J. Paed.

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“…The number of cells attached to the polymer surfaces was determined by hemocytometric counting. 16,17 The mean value of four replicates was used as the final result for each sample. Cell attachment was expressed as a proportion of the number of cells attached to TCPS in the same culture media.…”

Section: Cell Behaviormentioning

confidence: 99%

Surface engineering of poly(D,L‐lactic acid) by entrapment of chitosan‐based derivatives for the promotion of chondrogenesis

Zhu

Lin

et al. 2002

J. Biomed. Mater. Res.

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Chitosan and chitosan-amino acid derivatives were explored to engineer poly(D,L-lactic acid) (PDL-LA) as an extracellular matrix-like surface to promote cell adhesion and growth. Four kinds of chitosan-amino acid derivatives were prepared to mimic the carbohydrate moieties of cell matrix glycoprotein. The chitosan-amino acid derivatives were characterized by using Fourier transform infrared and ultraviolet spectra. The amino acid content on chitosan-amino acid derivatives was determined by using a ninhydrin-ultraviolet method. A new strategy, entrapment, was therefore used to modify the PDL-LA membrane with chitosan and chitosan-amino acid derivatives. The results of X-ray photoelectron spectroscopy, attenuated total reflectance-Fourier transform infrared, and contact angle confirmed that a stable thin film of chitosan and its derivatives can be entrapped on the surface of the PDL-LA membrane. From the results of chondrocyte cytocompatibility, MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide] assays, and cell morphology, the chitosan-amino acid derivative modified PDL-LA membranes were shown to promote chondrogenesis. The novel surface treatment method combines the good mechanical property of PDL-LA with the good cytocompatibility of chitosan derivatives, which may have potential for tissue engineering.

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“…VanNostrand and colleagues 17 found that 78.9% of samples containing nitrate-reducing bacteria were actually negative for nitrite on the urine dipstick. Therefore the presence of nitrite has a high positive predictive value of 94% 18 , but in the absence of urinary nitrite a UTI cannot be ruled out.…”

Section: Urinalysis Part 1: Urine Dipstickmentioning

confidence: 99%

“…If both tests are positive, the specificity increases to 98-99.5%, indicating a high likelihood of a UTI 14,19 . Several studies conclude that from this information alone a diagnosis of a UTI can be made and treatment initiated 2,18,20,21 . This clinical conclusion has recently been called into question by a study demonstrating a low sensitivity for both leukocyte esterase and nitrite but did not take into account the clinical presentation of the patients in the study 17 .…”

Section: Urinalysis Part 1: Urine Dipstickmentioning

confidence: 99%

Urinalysis and Urinary Tract Infection: Update for Clinicians

Young

Soper

2001

Infectious Diseases in Obstetrics and Gynecology

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Dysuria is a common presenting complaint of women and urinalysis is a valuable tool in the initial evaluation of this presentation. Clinicians need to be aware that pyuria is the best determinate of bacteriuria requiring therapy and that values significant for infection differ depending on the method of analysis. A hemocytometer yields a value of 10 WBC/mm 3 significant for bacteriuria, while manual microscopy studies show 8 WBC/high-power field reliably predicts a positive urine culture. In cases of uncomplicated symptomatic urinary tract infection, a positive value for nitrites and leukocyte esterase by urine dipstick can be treated without the need for a urine culture. Automated urinalysis used widely in large volume laboratories provides more sensitive detection of leukocytes and bacteria in the urine. With automated microscopy, a value of > 2 WBC/hpf is significant pyuria indicative of inflammation of the urinary tract. In complicated cases such as pregnancy, recurrent infection or renal involvement, further evaluation is necessary including manual microscopy and urine culture with sensitivities.

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Detection of pyuria and bacteriuria in symptomatic ambulatory women

Abstract: The standard urinalysis was the most accurate single method to predict significant bacteriuria in symptomatic ambulatory women. Sequencing the dipstick urinalysis with the standard urinalysis may be a cost-effective approach to evaluating these patients in clinical practice.

Cited by 34 publications

References 22 publications

Pyuria as a diagnostic test for urinary tract infection in children with sickle cell anaemia in Zaria, Nigeria

Pyuria as a diagnostic test for urinary tract infection in children with sickle cell anaemia in Zaria, Nigeria

Surface engineering of poly(D,L‐lactic acid) by entrapment of chitosan‐based derivatives for the promotion of chondrogenesis

Urinalysis and Urinary Tract Infection: Update for Clinicians

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