Observational studyJournal of clinical microbiology2015
Overdiagnosis of Urinary Tract Infection and Underdiagnosis of Sexually Transmitted Infection in Adult Women Presenting to an Emergency Department.
Observational study in Journal of clinical microbiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
49 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Sex disparities in chlamydia and gonorrhea treatment in U.S. adult emergency departments: A systematic review and meta-analysis.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Pooled it
- Outpatient management of urinary tract infections by medical officers in Nairobi, Kenya: lack of benefit from audit and feedback on adherence to treatment guidelines.BMC infectious diseases · 2023Trial
- Mobile Health Intervention to Reduce HIV Transmission: A Randomized Trial of Behaviorally Enhanced HIV Treatment as Prevention (B-TasP).Journal of acquired immune deficiency syndromes (1999) · 2018Trial
- Rapid screening of urinary tract infections: quantitative flow cytometry versus dipstick testing in a hospital cohort.Infection · 2026Article
- Urinary tract infections at an Australian sexual health service: bacterial etiologies, antibiotic susceptibilities, and antimicrobial prescribing patterns.Microbiology spectrum · 2026Article
- Article
- XGBoost (eXtreme Gradient Boosting) Can Predict Organisms Growing in Urine Culture from the Emergency Department.The western journal of emergency medicine · 2026Article
- Assessment of Inter-rater Variability in the Diagnosis of Urinary Tract Infections in the Emergency Department.The western journal of emergency medicine · 2026Article
- Clinical factors and diagnoses associated with inappropriate urine culture ordering in primary care.Infection control and hospital epidemiology · 2026Article
- Machine learning to predict bacteriuria in the emergency department.Scientific reports · 2025Article
- Clinical approach to sexually transmitted infections and pelvic inflammatory disease in women with acute pyelonephritis.The Korean journal of internal medicine · 2025Article
- Use of BacterioScan 216Dx to reduce antibiotic use for suspected urinary tract infection in the emergency department.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Predictive model for genital tract infections among men and women in Ghana: An application of LASSO penalized cross-validation regression model.Epidemiology and infection · 2024Article
- A step forward in the diagnosis of urinary tract infections: from machine learning to clinical practice.Computational and structural biotechnology journal · 2024Article
- Association Between Sexually Transmitted Infections and the Urine Culture.The western journal of emergency medicine · 2024Article
- Diagnostic and treatment patterns in urinary and genital tract infections: insights from a referral clinic in Beirut, Lebanon.World journal of urology · 2024Article
- Evaluation of the Diagnosis and Antibiotic Prescription Pattern in Patients Hospitalized with Urinary Tract Infections: Single-Center Study from a University-Affiliated Hospital.Antibiotics (Basel, Switzerland) · 2023Article
- Can the application of machine learning to electronic health records guide antibiotic prescribing decisions for suspected urinary tract infection in the Emergency Department?PLOS digital health · 2023Article
- Urogenital pathogens in urine samples of clinically diagnosed urinary tract infected patients in Tanzania: A laboratory based cross-sectional study.IJID regions · 2023Article
- Patient and Provider Demographics and the Management of Genitourinary Tract Infections in the Emergency Department.Emergency medicine international · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
Urinary tract infections (UTIs) and sexually transmitted infections (STIs) are commonly diagnosed in emergency departments (EDs). Distinguishing between these syndromes can be challenging because of overlapping symptomatology and because both are associated with abnormalities on urinalysis (UA). We conducted a 2-month observational cohort study to determine the accuracy of clinical diagnoses of UTI and STI in adult women presenting with genitourinary (GU) symptoms or diagnosed with GU infections at an urban academic ED. For all urine specimens, UA, culture, and nucleic acid amplification testing for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis were performed. Of 264 women studied, providers diagnosed 175 (66%) with UTIs, 100 (57%) of whom were treated without performing a urine culture during routine care. Combining routine care and study-performed urine cultures, only 84 (48%) of these women had a positive urine culture. Sixty (23%) of the 264 women studied had one or more positive STI tests, 22 (37%) of whom did not receive treatment for an STI within 7 days of the ED visit. Fourteen (64%) of these 22 women were diagnosed with a UTI instead of an STI. Ninety-two percent of the women studied had an abnormal UA finding (greater-than-trace leukocyte esterase level, positive nitrite test result, or pyuria). The positive and negative predictive values of an abnormal UA finding were 41 and 76%, respectively. In this population, empirical therapy for UTI without urine culture testing and overdiagnosis of UTI were common and associated with unnecessary antibiotic exposure and missed STI diagnoses. Abnormal UA findings were common and not predictive of positive urine cultures.
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