Diagnosis and Management of Urinary Tract Infections: Asymptomatic Bacteriuria, Cystitis, and Pyelonephritis

McBryde, Connor; Redington, Jay

doi:10.1097/00129300-200103000-00002

Cited by 3 publications

(2 citation statements)

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“…Exclusions were where other diagnoses were considered likely; (for example, patients with vaginal symptoms); 6 pregnant women; age over 70 years since the relation between symptoms and bacteriuria is likely to be different in older age groups; [22][23][24][25][26] and also current severe mental problems (for example, dementia) where patients would have difficulty with consenting and answering questions.…”

Section: Inclusion Criteriamentioning

confidence: 99%

Validating the prediction of lower urinary tract infection in primary care: sensitivity and specificity of urinary dipsticks and clinical scores in women

Little

Rumsby²,

Jones³

et al. 2010

Br J Gen Pract

107

119

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BackgroundDipsticks are one of the most commonly used nearpatient tests in primary care, but few clinical or dipstick algorithms have been rigorously developed. AimTo confirm whether previously documented clinical and dipstick variables and algorithms predict laboratory diagnosis of urinary tract infection (UTI). Design of studyValidation study. SettingPrimary care. MethodA total of 434 adult females with suspected lower UTI had bacteriuria assessed using the European Urinalysis Guidelines. ResultsSixty-six per cent of patients had confirmed UTI. The predictive values of nitrite, leucocyte esterase (+ or greater), and blood (haemolysed trace or greater) were confirmed (independent multivariate odds ratios = 5.6, 3.5, and 2.1 respectively). The previously developed dipstick rule -based on presence of nitrite, or both leucocytes and blood -was moderately sensitive (75%) but less specific (66%; positive predictive value [PPV] 81%, negative predictive value [NPV] 57%). Predictive values were improved by varying the cut-off point: NPV was 76% for all three dipstick results being negative; the PPV was 92% for having nitrite and either blood or leucocyte esterase. Urine offensive smell was not found to be predictive in this sample; for a clinical score using the remaining three predictive clinical features (urine cloudiness, dysuria, and nocturia), NPV was 67% for none of the features, and PPV was 82% for three features. ConclusionA clinical score is of limited value in increasing diagnostic precision. Dipstick results can modestly improve diagnostic precision but poorly rule out infection. Clinicians need strategies to take account of poor NPVs.

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Section: Inclusion Criteriamentioning

confidence: 99%

Validating the prediction of lower urinary tract infection in primary care: sensitivity and specificity of urinary dipsticks and clinical scores in women

Little

Rumsby²,

Jones³

et al. 2010

Br J Gen Pract

107

119

View full text Add to dashboard Cite

show abstract

“…Tratamientos más abreviados han tenido menores tasas de erradicación de bacterias en niños. Las bacteriurias asintomáticas (urocultivo positivo en paciente sin síntomas ni alteraciones en el sedimento urinario) no debieran tratarse, con excepción de las adolescentes embarazadas 6,19,20 .…”

Section: Elección De Antimicrobianos Según Edad Y Condición Clínica Dunclassified

Infección urinaria en la infancia

S.M.

2005

Rev. chil. infectol.

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Dipsticks and diagnostic algorithms in urinary tract infection: development and validation, randomised trial, economic analysis, observational cohort and qualitative study

Little¹,

Turner²,

Rumsby³

et al. 2009

Health Technol Assess

106

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Diagnosis and Management of Urinary Tract Infections: Asymptomatic Bacteriuria, Cystitis, and Pyelonephritis

Cited by 3 publications

References 0 publications

Validating the prediction of lower urinary tract infection in primary care: sensitivity and specificity of urinary dipsticks and clinical scores in women

Validating the prediction of lower urinary tract infection in primary care: sensitivity and specificity of urinary dipsticks and clinical scores in women

Infección urinaria en la infancia

Dipsticks and diagnostic algorithms in urinary tract infection: development and validation, randomised trial, economic analysis, observational cohort and qualitative study

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