Diagnostic value of dipstick test in adult symptomatic urinary tract infections: results of a cross-sectional Tunisian study
| Autor: | Wissem Hachfi, F. Bellazreg, Nadia Ben Lasfar, Maha Abid, Z. Hattab, Amel Letaief |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Urinary tract infection Adult patients business.industry diagnosis Urinary system 030231 tropical medicine dipstick test General Medicine Gold standard (test) Dipstick Urine Gastroenterology Empirical antibiotic therapy 03 medical and health sciences Leukocyte esterase nitrites 0302 clinical medicine Internal medicine medicine leukocyte esterase Uti symptoms Case Series 030212 general & internal medicine business |
| Zdroj: | The Pan African Medical Journal |
| ISSN: | 1937-8688 |
| Popis: | Urinary tract infections (UTIs) are common. The diagnosis is confirmed by urine culture which is costly and takes at least 24 hours before results are known. The aim of this study was to determine the diagnostic accuracy of dipstick test for the diagnosis of UTI in symptomatic adult patients. We conducted a cross-sectional study in the department of Infectious Diseases, Sousse-Tunisia during a two-year period. We included all patients with clinical signs of UTI. Urine samples were tested for the presence of leukocyte esterase (LE) and nitrites. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of LE and nitrites were calculated against urine culture as gold standard. Four hundred thirty one patients, 139 men (32%) and 292 women (68%) were included. One hundred sixty six patients (39%) had UTI. The most frequently isolated microorganism was Escherichia coli (75%). LE had a high sensitivity (87%) but a low specificity (64%), while nitrites had a high specificity (95%) but a low sensitivity (48%). Combined positive LE and nitrites had a high PPV (85%) and combined negative LE and nitrites had a high NPV (92%), while positive LE combined with negative nitrites had a low PPV (47%) and a low NPV (53%). In conclusion, in adult patients with UTI symptoms, an alternate diagnosis should be considered if the LE is negative, while an early empirical antibiotic therapy against Enterobacteriaceae should be started if the nitrites are positive. |
| Databáze: | OpenAIRE |
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