How accurate is the urine dipstick test for diagnosing urinary tract infection?

Year 2019, Volume: 5 Issue: 4, 613 - 617, 04.07.2019

Esra Paydaş Hataysal Beyza Saraçlıgil Hatice Türk Dağı Hüsamettin Vatansev

https://doi.org/10.18621/eurj.406215

Cited By: 1

Abstract

Objectives: Urine dipstick is the first
step laboratory test to diagnose a urinary tract infection (UTI) which is a common
infectious disease diagnosed
in the laboratories. Early treatment of UTI is very important in order to
prevent long-term complications. The gold standard to diagnose UTI is urine
culture so there are a number of unnecessary urine culture requests.  However, urine culture results are not available
earlier than 24-36 hours. Besides, urine culture is expensive and causes
time-consuming of treatment. Our aim in this study was to compare urine
leukocyte esterase test and nitrite test of urine dipstick with urine culture to determinate the sensitivity,
specificity, positive predictive value
(PPV) and negative predictive value (NPV).

Methods: Urine culture results and urine dipstick test results
of patients who admitted to Selçuk University Hospital between May 2016 and May
2017 were collected retrospectively. The study included 11.169 patients and
3299 of them have positive urine cultures.

Results: In total, 3299 (29.5%) patients
have positive urine culture. Out of these culture positive samples, positive
dipstick results’ ratios for leukocyte esterase and nitrite were 82.8% (n =
2733) and 22.4% (n = 774). Leukocyte esterase had
82.8% sensitivity and 68.1% specificity, with PPVs and NPVs of 52.1% and 90.5%,
respectively.

Conclusions: The NPVs are found significantly higher than PPVs
and it shows that urinary dipstick is more reliable to exclude disease than to
diagnose the disease. Clinicians should not order urine culture from all
patients without ant clinic signs. 

Keywords

Urine culture, nitrite, leukocyte esterase, urine dipstick, urine analysis

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