Year 2019, Volume 5, Issue 4, Pages 613 - 617 2019-07-04

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

Esra Paydaş Hataysal [1] , Beyza Saraçlıgil [2] , Hatice Türk Dağı [3] , Hüsamettin Vatansev [4]

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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. 

Urine culture, nitrite, leukocyte esterase, urine dipstick, urine analysis
  • [1] Patel HD, Livsey SA, Swann RA, Bukhari SS. Can urine dipstick testing for urinary tract infection at point of care reduce laboratory workload? J Clin Pathol 2005;58:951-4.
  • [2] Mambatta A, Jayarajan J, Rashme VL, Harini S, Menon S, Kuppusamy J. Reliability of dipstick assay in predicting urinary tract infection. J Family Med Prim Care 2015;4:265-8.
  • [3] Kayalp D, Dogan K, Ceylan G, Senes M, Yucel D. Can routine automated urinalysis reduce culture requests? Clin Biochem 2013;46:1285-9.
  • [4] Williams GJ, Macaskill P, Chan SF, Turner RM, Hodson E, Craig JC. Absolute and relative accuracy of rapid urine tests for urinary tract infection in children: a metaanalysis. Lancet Infect Dis 2010;10:240-50.
  • [5] Memişoğulları R, Yüksel H, Ak Yıldırım H, Yavuz Ö. Performance characteristics of dipstick and microscopic urinalysis for diagnosis of urinary tract infection. Eur J Gen Med 2010;7:174-8.
  • [6] Whiting P, Westwood M, Watt I, Cooper J, Kleijnen J. Rapid tests and urine sampling techniques for the diagnosis of urinary tract infection (UTI) in children under five years: a systematic review. BMC Pediatr 2005;5:4.
  • [7] John AS, Boyd JC, Lowes AJ, Price CP. Clinical Chemistry/Use of dipstick testing to rule out UTI. Am J Clin Pathol 2006;126:428-36.
  • [8] Fahey T, Webb E, Montgomery AA, Heyderman RS. Clinical management of urinary tract infection in women: a prospective cohort study. Fam Pract 2003;20:1-6.
  • [9] Devillé W, Yzermans JC, van Duijn NP, Bezemer PD, wan der Windt D, Bouter LM. The urine dipstick test useful to rule out infections. A meta-analysis of the accuracy. BMC Urol 2004;4:4.
  • [10] Okada H, Sakai Y, Miyazaki S, Arakawa S, Hamaguchi Y, Kamidono S. Detection of significant bacteriuria by automatedurinalysis using flow cytometry. J Clin Microbiol 2000;38:2870-2.
  • [11] Christenson RH, Tucker JA, Allen E. Results of dipstick tests, visual inspection, microscopic examination of urine sediment, and microbiological cultures of urine compared for simplifying urinalysis. Clin Chem 1985;31:448-51.
  • [12] Öztürk A, Gınıs Z, Hancı T, Yıldız Z, Taşlıpınar MY, Uçar F, et al. Evaluation of diagnostic performance of routine automated urinalysis and association between urinary tract infection and leukocytosis. Acta Medica 2015;4: 42-7.
  • [13] Mambatta AK, Jayarajan J, Rashme VL, Harini S, Menon S, Kuppusamy J. Reliability of dipstick assay in predicting urinary tract infection. J Family Med Prim Care 2015;4:265-8.
  • [14] Ercan Ş, Yücel N, Özer RS, Kaptanağası Orçun A. [Evaluation of diagnostic performances of nitrite and leukocyte esterase with respect to age and gender]. Türk Klinik Biyokimya Derg 2014;12:91-8. [Article in Turkish]
  • [15] Najeeb S, Munir T, Rehman S, Hafiz A, Gilani M, Latif M. Comparison of urine dipstick test with conventional urine culture in diagnosis of urinary tract infection. J Coll Physicians Surg Pak 2015;25:108-10.
Primary Language en
Subjects Health Care Sciences and Services
Journal Section Original Articles
Authors

Orcid: 0000-0002-3538-8135
Author: Esra Paydaş Hataysal (Primary Author)
Institution: Department of Biochemistry, Selçuk University School of Medicine, Konya, Turkey
Country: Turkey


Orcid: 0000-0003-3147-3719
Author: Beyza Saraçlıgil
Institution: Department of Biochemistry, Karatay University School of Medicine, Konya, Turkey
Country: Turkey


Orcid: 0000-0002-0291-4987
Author: Hatice Türk Dağı
Institution: Department of Microbiology, Selçuk University School of Medicine, Konya, Turkey
Country: Turkey


Orcid: 0000-0002-0230-3414
Author: Hüsamettin Vatansev
Institution: Department of Biochemistry, Selçuk University School of Medicine, Konya, Turkey
Country: Turkey


Dates

Publication Date: July 4, 2019

EndNote %0 The European Research Journal How accurate is the urine dipstick test for diagnosing urinary tract infection? %A Esra Paydaş Hataysal , Beyza Saraçlıgil , Hatice Türk Dağı , Hüsamettin Vatansev %T How accurate is the urine dipstick test for diagnosing urinary tract infection? %D 2019 %J The European Research Journal %P -2149-3189 %V 5 %N 4 %R doi: 10.18621/eurj.406215 %U 10.18621/eurj.406215