Skip to main content
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1998 Jun;51(6):471–472. doi: 10.1136/jcp.51.6.471

Disappointing dipstick screening for urinary tract infection in hospital inpatients.

Z Zaman 1, A Borremans 1, J Verhaegen 1, L Verbist 1, N Blanckaert 1
PMCID: PMC500752  PMID: 9771448

Abstract

AIM: To compare the performance of leucocyte esterase and nitrite dipstick tests with microscopic examination and culture of first morning urines (n = 420) of hospital inpatients. RESULTS: The sensitivity, specificity, and negative predictive value of the leucocyte esterase test for the cutoff of > 10 WBC/microliter were 57%, 94%, and 68%, respectively. For > 5 WBC per high power field (HPF) these variables were 84%, 90%, and 93%. For > 10(5) colony counts/ml, the sensitivity of the nitrite test was 27%, specificity 94%, and negative predictive value 87%. When either leucocyte esterase or nitrite positivity was accepted as a marker of urinary tract infection, the sensitivity was 78%, specificity 75%, and negative predictive value 94%, and there were 22% false negative results. Semiquantitative microscopic estimation of bacteria per HPF yielded 40% false positives. CONCLUSIONS: Leucocyte esterase and nitrite dipstick tests are not suitable for screening for urinary tract infections.

Full text

PDF
471

Selected References

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

  1. Bachman J. W., Heise R. H., Naessens J. M., Timmerman M. G. A study of various tests to detect asymptomatic urinary tract infections in an obstetric population. JAMA. 1993 Oct 27;270(16):1971–1974. [PubMed] [Google Scholar]
  2. Molyneux E. M., Robson W. J. A dipstick test for urinary tract infections. J Accid Emerg Med. 1995 Sep;12(3):191–193. doi: 10.1136/emj.12.3.191. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Patrick D. M., Rekart M. L., Knowles L. Unsatisfactory performance of the leukocyte esterase test of first voided urine for rapid diagnosis of urethritis. Genitourin Med. 1994 Jun;70(3):187–190. doi: 10.1136/sti.70.3.187. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Propp D. A., Weber D., Ciesla M. L. Reliability of a urine dipstick in emergency department patients. Ann Emerg Med. 1989 May;18(5):560–563. doi: 10.1016/s0196-0644(89)80844-3. [DOI] [PubMed] [Google Scholar]
  5. Woodward M. N., Griffiths D. M. Use of dipsticks for routine analysis of urine from children with acute abdominal pain. BMJ. 1993 Jun 5;306(6891):1512–1512. doi: 10.1136/bmj.306.6891.1512. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES