Diagnostic Value of Various Urine Tests in the Jordanian Population with Urinary Tract Infection

Abstract

We compared the performance of leukocyte esterase and nitrite reductase dipstick tests with microscopic examination and uroculture in cases with clinically suspected urinary tract infection (UTI). We studied urine specimens from 504 Jordanian patients which were obtained by the mid-stream clean catch method and analyzed for bacteria. All samples were subjected to culture. Results of urine dipstick tests and pyuria (white blood cells (WBC)/high power field) were compared with urine culture for each sample. Significant bacteriuria was found in 117 cases (23.2%) with positivity of 59% and 68.5% for the presence of nitrite reductase and leukocyte esterase, respectively. Echerichia coli was the most common organism isolated. The dipstick leukocyte esterase and nitrite testing had a sensitivity of 68.5% and 59% for detecting bacteriuria in UTI cases and specificity of 73.5% and 78%, respectively. The positive predictive value of the tests was 44% and 60%, and the negative predictive value 88.5% and 86.2%, respectively. Microscopic WBC showed 86.5% specificity but low sensitivity. Urine dipstick results and pyuria significantly correlated with the results of urine culture but demonstrated more false-positive results, which ranged from 13.4-26.6%. The probability of growing a urinary pathogen correlated with urinary WBC counts and allowed prediction of the presence or absence of bacteriuria by counting urinary leukocytes. A combination of pyuria and urine dipstick testing appears to be a very useful marker for the diagnosis of UTI. Urine culture can be omitted if both tests are negative.

Precisão da tira reagente e do exame microscópico da urina no diagnóstico de infecções do trato urinário em porcas

“…The authors suggest that both urine analysis methods can be used for a quick diagnostic. Other authors obtained similar results (Vangone & Russo 1985, Vickers et al 1991, Lohr et al 1993, Al-Daghistani & Abdel-Dayem 2002. Taneja et al (2010) evaluated the usefulness of the reagent strip (leukocyte esterase and nitrite) and of the microscopic examination of the urine for diagnosing UTI and concluded that these techniques must be used jointly for added safety in quickly UTI diagnosing.…”

Prevalence of Urinary Tract Infections and Their Antimicrobial Sensitivity Among Diabetic and Non Diabetic Patients in Zakho

“…The increased risk of infection in diabetic patients can be partially explained by a reduced T-cell mediated immune response and impaired neutrophil function among diabetics (Zhanel, Nicolle, & Harding, 1995). Other factors such as local complications related to neuropathy including impaired bladder emptying and higher glucose concentrations in urine may also play a role in increased incidences of UTI in diabetics (Al-Daghistani & Abdel-Dayem, 2002). Patients with diabetes mellitus react with the health care system more frequently and more intensively than the general population (Hvidberg et al, 2000).…”

Evaluation of new American Academy of Pediatrics guideline for febrile urinary tract infection

“…Our results show a lower level of urine SG in patients with only positive urine culture findings than in other two groups even though the mean level of that were within normal range. In addition, false-negative WBC count might be obtained in case of lysis or the absence of inflammatory response in colonized (rather than infected) individuals 11) . Urine culture findings are the reference standard for the diagnosis of UTI, but negative culture findings are often observed in various clinical settings; partially treated bacterial UTIs, viral infections and UTI in the presence of urinary obstruction 1) .…”