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. 1987 Mar;25(3):467–470. doi: 10.1128/jcm.25.3.467-470.1987

Clinical evaluation of three urine screening tests.

P R Murray, T B Smith, T C McKinney Jr
PMCID: PMC265953  PMID: 3571450

Abstract

Evaluations of screening tests for bacteriuria have traditionally compared the test results with those of quantitative urine cultures. However, many patients with symptomatic urinary tract infections can have less than 10(5) CFU/ml in their urine. Therefore, the results of urine culture and three screening tests (Bac-T-Screen, Chemstrip LN [which tests for leukocyte esterase and nitrate reductase], and Gram stain) were correlated with the clinical classification of urinary tract infection. The Bac-T-Screen test detected 98, 93, and 100% of the infections classified as probable, possible, and asymptomatic, respectively. In contrast, the Gram stain, leukocyte esterase, and nitrate reductase tests were all insensitive screening tests for infection. Additionally, only 45% of the patients with probable infections had greater than or equal to 10(5) CFU/ml. Thus, the majority of infected patients would not have been detected if quantitative urine cultures were used alone.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barr R. H., Rantz L. A. THE INCIDENCE OF UNSUSPECTED URINARY TRACT INFECTION IN A SELECTED GROUP OF AMBULATORY WOMEN. Calif Med. 1948 Jun;68(6):437–440. [PMC free article] [PubMed] [Google Scholar]
  2. Jenkins R. D., Fenn J. P., Matsen J. M. Review of urine microscopy for bacteriuria. JAMA. 1986 Jun 27;255(24):3397–3403. [PubMed] [Google Scholar]
  3. KASS E. H. Asymptomatic infections of the urinary tract. Trans Assoc Am Physicians. 1956;69:56–64. [PubMed] [Google Scholar]
  4. KASS E. H. Bacteriuria and the diagnosis of infections of the urinary tract; with observations on the use of methionine as a urinary antiseptic. AMA Arch Intern Med. 1957 Nov;100(5):709–714. doi: 10.1001/archinte.1957.00260110025004. [DOI] [PubMed] [Google Scholar]
  5. Komaroff A. L. Acute dysuria in women. N Engl J Med. 1984 Feb 9;310(6):368–375. doi: 10.1056/NEJM198402093100607. [DOI] [PubMed] [Google Scholar]
  6. Komaroff A. L. Urinalysis and urine culture in women with dysuria. Ann Intern Med. 1986 Feb;104(2):212–218. doi: 10.7326/0003-4819-104-2-212. [DOI] [PubMed] [Google Scholar]
  7. Kusumi R. K., Grover P. J., Kunin C. M. Rapid detection of pyuria by leukocyte esterase activity. JAMA. 1981 Apr 24;245(16):1653–1655. [PubMed] [Google Scholar]
  8. Latham R. H., Wong E. S., Larson A., Coyle M., Stamm W. E. Laboratory diagnosis of urinary tract infection in ambulatory women. JAMA. 1985 Dec 20;254(23):3333–3336. [PubMed] [Google Scholar]
  9. Pezzlo M. T., Wetkowski M. A., Peterson E. M., de la Maza L. M. Detection of bacteriuria and pyuria within two minutes. J Clin Microbiol. 1985 Apr;21(4):578–581. doi: 10.1128/jcm.21.4.578-581.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Pfaller M. A., Baum C. A., Niles A. C., Murray P. R. Clinical laboratory evaluation of a urine screening device. J Clin Microbiol. 1983 Sep;18(3):674–679. doi: 10.1128/jcm.18.3.674-679.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Pfaller M. A., Koontz F. P. Laboratory evaluation of leukocyte esterase and nitrite tests for the detection of bacteriuria. J Clin Microbiol. 1985 May;21(5):840–842. doi: 10.1128/jcm.21.5.840-842.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Pollock H. M. Laboratory techniques for detection of urinary tract infection and assessment of value. Am J Med. 1983 Jul 28;75(1B):79–84. doi: 10.1016/0002-9343(83)90076-1. [DOI] [PubMed] [Google Scholar]
  13. SANFORD J. P., FAVOUR C. B., MAO F. H., HARRISON J. H. Evaluation of the positive urine culture; an approach to the differentiation of significant bacteria from contaminants. Am J Med. 1956 Jan;20(1):88–93. doi: 10.1016/0002-9343(56)90175-9. [DOI] [PubMed] [Google Scholar]
  14. Slosky D. A., Todd J. K. Diagnosis of urinary tract infection. The interpretation of colony counts. Clin Pediatr (Phila) 1977 Aug;16(8):698–701. doi: 10.1177/000992287701600804. [DOI] [PubMed] [Google Scholar]
  15. Stamey T. A., Pfau A. Urinary infections: a selective review and some observations. Calif Med. 1970 Dec;113(6):16–35. [PMC free article] [PubMed] [Google Scholar]
  16. Stamm W. E., Counts G. W., Running K. R., Fihn S., Turck M., Holmes K. K. Diagnosis of coliform infection in acutely dysuric women. N Engl J Med. 1982 Aug 19;307(8):463–468. doi: 10.1056/NEJM198208193070802. [DOI] [PubMed] [Google Scholar]
  17. Stamm W. E., Wagner K. F., Amsel R., Alexander E. R., Turck M., Counts G. W., Holmes K. K. Causes of the acute urethral syndrome in women. N Engl J Med. 1980 Aug 21;303(8):409–415. doi: 10.1056/NEJM198008213030801. [DOI] [PubMed] [Google Scholar]
  18. Stark R. P., Maki D. G. Bacteriuria in the catheterized patient. What quantitative level of bacteriuria is relevant? N Engl J Med. 1984 Aug 30;311(9):560–564. doi: 10.1056/NEJM198408303110903. [DOI] [PubMed] [Google Scholar]

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