Near-patient testing for infection using urinalysis and immuno-chromatography strips
Autor: | Ronald G Sommer, Paul F Corey, Darryl L. Gopual, Michael J. Pugia, John A. Lott, Hai-Hang Kuo |
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Rok vydání: | 2004 |
Předmět: |
Male
Antibody-Coated Bacteria Test Urinary Bacteriuria Urinalysis Clinical Biochemistry Clinical Chemistry Tests Urine Gram-Positive Bacteria medicine.disease_cause Microbiology Leukocyte Count Predictive Value of Tests Reference Values Gram-Negative Bacteria Escherichia coli medicine Humans False Positive Reactions False Negative Reactions Nitrites Reagent Strips Urine cytology Immunoassay medicine.diagnostic_test Diagnostic Tests Routine business.industry Biochemistry (medical) Diagnostic Techniques Urological General Medicine medicine.disease Microspheres Leukocyte esterase Predictive value of tests Urinary Tract Infections Immunology Erythrocyte Count Female Fluorescein business Carboxylic Ester Hydrolases |
Zdroj: | Clinical Chemistry and Laboratory Medicine (CCLM). 42 |
ISSN: | 1437-4331 1434-6621 |
Popis: | Urinary tract infections require costly confirmatory tests such as a urine culture to establish the diagnosis. Elimination of the culture step would save resources; diagnosis and treatment could begin in hours rather than days. We tested a new dip-and-read strip that uses immuno-chromatography (IC) to detect infectious agents in urine. We used a goat-derived polyclonal antibody with reactivity to the cell-wall proteins of Escherichia coli (E. coli). Fluorescein linked to the anti-E. coli antibody served to trap the bacteria on a strip coated with an anti-fluorescein mouse antibody. Blue latex particles were linked to anti-E. coli antibodies by standard methods and were used for detection of E. coli. We found that the combination of leukocyte esterase and nitrite dipsticks gave negative predictive values of 93% for culture-negative urines, i.e., there were very few false-negative results. Using the same dipsticks on culture-positive specimens, the positive predictive values were unacceptably low; we obtained too many false-positive values. By contrast, the IC strips gave negative predictive values of 89%. The major advantage of the IC strips is that the positive predictive values were higher, i.e., there were fewer false-positive results. The combined use of both IC strips and urinalysis dipsticks offers the best strategy for diagnosing infection with dipsticks. The IC strip test could reduce the necessity of a urine culture in patients with suspected infections and provide rapid point-of-care testing. |
Databáze: | OpenAIRE |
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