Dipstick urinalysis screening of asymptomatic adults for urinary tract disorders. II. Bacteriuria

Pels, Richard J.; Bor, David H.; Woolhandler, Steffie; Himmelstein, David U.; Lawrence, Robert S.

doi:10.1001/jama.262.9.1221

Cited by 63 publications

(18 citation statements)

References 56 publications

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“…The sensitivity of positive nitrite in relation to positive Uricult A (Table IV), was comparable to results from other studies (5,(18)(19)(20)(21), but the specificity and positive predictive values were much lower. The sensitivity of positive nitrite in relation to positive Uricult A (Table IV), was comparable to results from other studies (5,(18)(19)(20)(21), but the specificity and positive predictive values were much lower.…”

Section: Nitritesupporting

confidence: 85%

The diagnosis of urinary tract infections among pregnant women in rural Tanzania; prevalences and correspondence between different diagnostic methods

Olsen¹,

Hinderaker²,

Lie³

et al. 2000

Acta Obstet Gynecol Scand

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Background. To assess the prevalence of dysuria, dipsticks positive on nitrite and leukocyte esterase and positive Uricult A dip slides among pregnant women in rural Tanzania. Methods. 3715 pregnant women were examined for dysuria and had their urine tested with nitrite and leukocyte esterase dipsticks and Uricult A dipslides, at their first antenatal visit in 1995-96. Results. The prevalences of positive symptoms and tests were as follows: dysuria 32%, nitrite 40.3%, leukocyte esterase 65.6%, and Uricult A dip slides 16.4%. A general log-linear model where all four variables were analyzed simultaneously showed poor correspondence between the diagnostic methods. Odds ratio with 95% confidence intervals were as follows: dysuria vs. nitrite [1.6 (1.4-1.8)], dysuria vs. leukocyte esterase [1.2 (1.0-1.4)], nitrite vs. leukocyte esterase [4.2 (3.6-4.9)], and leukocyte esterase vs. Uricult A [1.4 (1. 1-1.7)]. Dysuria and nitrite were not associated with Uricult A dipslide. Conclusion. A high prevalence of positive tests, but a poor correspondence between the methods was found, emphasizing the need for more attention to the problem of urinary tract infections among pregnant women in developing countries, and the need for better screening tests for urinary tract infections in these countries.

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Section: Nitritesupporting

confidence: 85%

The diagnosis of urinary tract infections among pregnant women in rural Tanzania; prevalences and correspondence between different diagnostic methods

Olsen¹,

Hinderaker²,

Lie³

et al. 2000

Acta Obstet Gynecol Scand

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“…The absence of bacterial growth in the urine was a poor predictor for the absence of leukocytes in the urine, with a negative predictive value of only 27%. In other populations, the leukocyte esterase test has been reported to have a sensitivity of 72 to 97% (12). The leukocyte esterase test in this population had a sensitivity of 71 % with a positive predictive value for pyuria of 99% but a negative predictive value of only 30%; specimens with pyuria and negative esterase tests tended, however, to h ave lower leukocyte counts .…”

Section: Discussionmentioning

confidence: 55%

Pyuria in Institutionalized Elderly Subjects

Rodgers

Nicolle

McIntyre

et al. 1990

Canadian Journal of Infectious Diseases and Medical Microbiolog

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in institutionalized e lderly subjects. Can J Infe ct Dis 199 1;2(4 ):142-146. Two hundred and forty-three wine specimens from 76 elderly institutionalized residents were obtained for urine culture, quantitative leukocyte count and winalysis. Significant bacteriuria was present in 153 specimens (63%), including 33 (22%) with more than one organism. Pyuria (greater than or equal to 10 leukocytes/mm3 ) was present in 214 specimens (88%). including 116 (97%) with single organism bacteriuria, 27 (82%) with multiple organism bacteriuria, and 71 (80%) without significant bacteriuria. The leukocyte esterase test had a positive predictive value of 99% for pyuria but a negative predictive value of only 30%. The quantitative level of pyuria was associated with the level of proteinuria and inversely with pH. A relatively constant level of pyuria tended to persist over months to years in a given individual if bacteriuria persisted. Pyuria is significantly associated with bacteriuria in the institutionalized elderly, but is also common in the nonbacteriuric. The clinical significance of pyuria requires further assessment. (3,5,6), and is highest in the most disabled. In the absence of a chronic indwelling catheter, bacteriuria is associated with relatively low morbidity, and treatment with antibiotics is followed by early recurrence (1,2). It has been suggested, however, that the presence of pyuria in individuals with bacteriuria is an indicator of infection of the urinary tract rather than 'colonization', and that pyuria is an indication for therapy. The validity of treatment decisions based on the presence or absence of pyuria has not been reported.This study was undertaken to determine some of the characteristics of pyuria in a group of institutionalized elderly subjects. The association of pyuria with bacteriuria and other urinary characteristics including pH, protein and glucose measurements, type of infecting organism, and the leukocyte esterase test were examined. Some observations on the natural history of pyuria are also reported, including degree of variability in the same individual over time. PATIENTS AND METHODS Patient population:The population studied included 57 males and 19 females, 32% of the 239 permanent residents of the Deer Lodge Centre, an extended care facility in Winnipeg, Manitoba. The mean age was 80 years (range 50 to 95). All participants had a high level of functional disability. Urine specimens were collected from a convenience sample of residents for a study characterizing some features of asymptomatic bacteriuria in this population. Nursing staff collected specimens from one individual whom they felt had bacteriuria based on a subjective assessment of smell and cloudiness, and from a second individual on the same ward whom they thought did not have infection. Residents with symptomatic bacteriuria characterized by symptoms of dysuria, frequency, urgency, hematuria, acute alteration in continence status, suprapubic discomfort, or signs of epididymo-orchitis or bacteremia, were excluded. Micro...

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“…Urobilinogen is a conjugated product of bilirubin, which passes through the bile duct and is metabolized in the intestine [40,41]. High levels of urobilinogen, urea, creatinine, protein and albumin in urine reflect the kidney dysfunction and renal injuries induced by KBrO 3 treatment [42,43].…”

Section: Discussionmentioning

confidence: 99%

Protective effects of rutin against potassium bromate induced nephrotoxicity in rats

Khan

Sahreen³

2012

BMC Complement Altern Med

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BackgroundRutin, a polyphenolic flavonoid, was investigated for its protective effects against the KBrO3 induced renal injuries in rat.MethodsGroup I was control (untreated), group II was given saline 0.5 ml/kg bw (0.9% NaCl), group III was administered KBrO3 (20 mg/kg bw) intragastric twice a week for four weeks. Rutin was administered to group VI (50 mg/kg bw) and Group V (70 mg/kg bw) along with KBrO3 (20 mg/kg bw) while group VI was given rutin (70 mg/kg bw) alone twice a week for four weeks. Protective effects of rutin on KBrO3-induced nephrotoxicity in rats were determined for biochemical parameter of urine, and serum, various antioxidant enzymes, DNA and histopathological damages in kidneys.ResultsThe level of urinary red blood cells, leucocytes count, specific gravity, urea, creatinine and urobilinogen was increased (P<0.01) whereas creatinine clearance was reduced. Serum level of protein, albumin, globulin, nitrite, creatinine and blood urea nitrogen (BUN) was significantly increased (P<0.01) by KBrO3. Marked histopathological lesions, elevated DNA fragmentation and AgNORs count in renal tissues was determined. Activity of antioxidant enzymes; catalase, superoxide dismutase, glutathione peroxidase, glutathione-S-transferase, glutathione reductase, and reduced glutathione contents were decreased (P<0.01) while thiobarbituric acid reactive substances were increased (P<0.01) with KBrO3 treatment in kidneys. DNA ladder assay was intimately related with the DNA fragmentation assay. Telomerase activity was found positive in the KBrO3 treated kidneys. Treatment with rutin effectively ameliorated the alterations in the studied parameters of rat. Rutin administration alone to rats did not exhibit any significant change in any of the parameters studied.ConclusionThese results suggest that rutin works as an antioxidant in vivo by scavenging reactive oxygen species and this serves to prevent oxidative renal damage in rat treated with KBrO3.

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Dipstick urinalysis screening of asymptomatic adults for urinary tract disorders. II. Bacteriuria

Cited by 63 publications

References 56 publications

The diagnosis of urinary tract infections among pregnant women in rural Tanzania; prevalences and correspondence between different diagnostic methods

The diagnosis of urinary tract infections among pregnant women in rural Tanzania; prevalences and correspondence between different diagnostic methods

Pyuria in Institutionalized Elderly Subjects

Protective effects of rutin against potassium bromate induced nephrotoxicity in rats

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