The urine dipstick test useful to rule out infections. A meta-analysis of the accuracy

Devillé, W.L.J.M.; Yzermans, Joris; Duijn, N. P. van; Bezemer, P.D.; Windt, D.A.W.M. van der; Bouter, Lex M.

doi:10.1186/1471-2490-4-4

Cited by 413 publications

(325 citation statements)

References 71 publications

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“…This first step should generate very few false-negative results and should have a high negative predictive value. However, screening by dipstick alone carries the risk of missing infections and other urinary diseases (13)(14)(15)(16). In this study we confirmed the low sensitivity and negative predictive value of this traditional approach and found that screening by dipstick combined with automated urine analysis strongly reduced the rate of false-negative results.…”

Section: Discussionsupporting

confidence: 75%

Automated urinalysis: first experiences and a comparison between the Iris iQ200 urine microscopy system, the Sysmex UF-100 flow cytometer and manual microscopic particle counting

Shayanfar

Tobler

Eckardstein

et al. 2007

Clinical Chemical Laboratory Medicine

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Background: Automated analysis of insoluble urine components can reduce the workload of conventional microscopic examination of urine sediment and is possibly helpful for standardization. We compared the diagnostic performance of two automated urine sediment analyzers and combined dipstick/automated urine analysis with that of the traditional dipstick/ microscopy algorithm. Methods: A total of 332 specimens were collected and analyzed for insoluble urine components by microscopy and automated analyzers, namely the Iris iQ200 (Iris Diagnostics) and the UF-100 flow cytometer (Sysmex). Results: The coefficients of variation for day-to-day quality control of the iQ200 and UF-100 analyzers were 6.5% and 5.5%, respectively, for red blood cells. We reached accuracy ranging from 68% (bacteria) to 97% (yeast) for the iQ200 and from 42% (bacteria) to 93% (yeast) for the UF-100. The combination of dipstick and automated urine sediment analysis increased the sensitivity of screening to approximately 98%. Conclusions: We conclude that automated urine sediment analysis is sufficiently precise and improves the workflow in a routine laboratory. In addition, it allows sediment analysis of all urine samples and thereby helps to detect pathological samples that would have been missed in the conventional two-step procedure according to the European guidelines. Although it is not a substitute for microscopic sediment examination, it can, when combined with dipstick testing, reduce the number of specimens submitted to microscopy. Visual microscopy is still required for some samples, namely, dysmorphic erythrocytes, yeasts, Trichomonas, oval fat bodies, differentiation of casts and certain crystals. Clin Chem Lab Med 2007;45: 1251-6.

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Section: Discussionsupporting

confidence: 75%

Automated urinalysis: first experiences and a comparison between the Iris iQ200 urine microscopy system, the Sysmex UF-100 flow cytometer and manual microscopic particle counting

Shayanfar

Tobler

Eckardstein

et al. 2007

Clinical Chemical Laboratory Medicine

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“…The reagent strip has not only been used to rule out urinary tract infections for a long time with similar performance of detecting this kind of infection [23], but also to help diagnose patients with other biological fluid infections such as meningitis and empyema [16][17][18]. The use of those strips in ascitic fluid has had good results in the diagnosis of peritonitis in patients on peritoneal dialysis [24,25].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of reagent strips for ascitic fluid leukocyte determination: is it a possible alternative for spontaneous bacterial peritonitis rapid diagnosis?

Ribeiro¹,

Kondo²,

Amaral³

et al. 2007

Braz J Infect Dis

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) for the rapid bedside diagnosis of spontaneous bacterial peritonitis. The mean age 54 ± 12 years, there was a predominance of males (eighty-two patients, 77%), and alcohol was the most frequent etiology (43%). Forty-four percent of patients were classified as Child B and fifty-one as Child C (51%). Abdominal paracentesis was performed both in outpatient and inpatient settings and the Multistix 10SG® ® ® ® ® was tested. Eleven cases of spontaneous bacterial peritonitis were identified by means of polymorphonuclear count. If we considered the positive Multistix 10SG® ® ® ® ® result of 3 or more, the sensitivity, specificity, positive and negative predictive value were respectively 71%, 99%, 91% and 98%. With a positive reagent strip result taken as grade 2 (traces) or more, sensitivity was 86% and specificity was 96% with positive and negative predictive values of 60% and 99%, respectively. Diagnostic accuracy was 95%. We concluded that the use of a urine reagent dipstick (Multistix 10SG® ® ® ® ®) could be considered a quick, easy and cheap method for ascitic fluid cellularity determination in SBP diagnosis.

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“…All patients had their urine screened with dipstick testing. This has previously been shown to be a reliable screen [5], and positive samples were sent for culture and microscopy. In line with local policy 105 organisms/ml was defined as a positive culture.…”

Section: Methodsmentioning

confidence: 99%

Asymptomatic urinary tract colonisation predisposes to superficial wound infection in elective orthopaedic surgery

Ollivere

Ellahee

Logan

et al. 2008

International Orthopaedics (SICOT)

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There is no evidence surrounding the benefits, effects or clinical outcomes treating asymptomatic urinary tract colonisation. A series of 558 patients undergoing elective admission for orthopaedic surgery were recruited prior to surgery and were screened for urinary tract infection (UTI). Patients had their urine dipstick tested and positive samples were sent for culture and microscopy. Patients with a positive urine culture were treated with antibiotics prior to surgery; 85% of dipsticks tested were positive, while only 7% of the urine samples were culture positive. Over 36% of patients with a pre-operative UTI show some form of postoperative delayed wound healing or confirmed infection versus 16% in the other subgroup giving a relative risk of wound complications of 2:1 (p<0.02). We have established that patients who present to pre-admission with urinary tract colonisation are a high risk subgroup for wound infection post-operatively.Résumé L'analyse d'urine est une pratique pré-opératoire habituelle en chirurgie orthopédique. Il n'y a pas d'évi-dence à traiter, a priori, les infections du tractus urinaires.Méthode: une série de 558 patients admis en chirurgie orthopédique et hospitalisés avant une intervention chirurgicale ont bénéficié d'une analyse urinaire systématique. Les patients présentant des tests positifs ont bénéficié par ailleurs d'une culture et d'un examen au microscope. Les patients présentant des cultures urinaires positives (plus de 105 colonies par mml) ont été traités par antibiotiques avant l'intervention chirurgicale. Résultats: 85% des analyses étaient positives, 7% seulement présentaient des cultures positives. 36% des patients qui avaient une infection urinaire pré-opératoire ont montré, en post-opératoire des problèmes de cicatrisation ou d'infection, versus 16% dans l'autre sous-groupe ceci donnant, pour cet autre sousgroupe un risque relatif de complications profondes de 2/1 (p<0,02). En conclusion, les cultures d'urine en pré-opératoire doivent être poursuivies chez tous les patients devant bénéficier d'une chirurgie orthopédique d'autant que les patients qui présentaient à l'admission une infection du tractus urinaire étaient à haut risque de complications profondes en post-opératoire.

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The urine dipstick test useful to rule out infections. A meta-analysis of the accuracy

Cited by 413 publications

References 71 publications

Automated urinalysis: first experiences and a comparison between the Iris iQ200 urine microscopy system, the Sysmex UF-100 flow cytometer and manual microscopic particle counting

Automated urinalysis: first experiences and a comparison between the Iris iQ200 urine microscopy system, the Sysmex UF-100 flow cytometer and manual microscopic particle counting

Evaluation of reagent strips for ascitic fluid leukocyte determination: is it a possible alternative for spontaneous bacterial peritonitis rapid diagnosis?

Asymptomatic urinary tract colonisation predisposes to superficial wound infection in elective orthopaedic surgery

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