ArticlePloS one2017
Sensitivity of the dipstick in detecting bacteremic urinary tract infections in elderly hospitalized patients.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Laboratory Tests, Bacterial Resistance, and Treatment Options in Adult Patients Hospitalized with a Suspected Urinary Tract Infection.Diagnostics (Basel, Switzerland) · 2024Review
- Review
- Toilet-based continuous health monitoring using urine.Nature reviews. Urology · 2022Review
- Article
- Presence of urinary symptoms in bacteremic urinary tract infection: a retrospective cohort study of Escherichia coli bacteremia.BMC infectious diseases · 2020Article
- Article
- Assessing the Utility of Ultrasound and Urinalysis for Patients with Possible Epididymo-Orchitis - A Retrospective Study.Open access emergency medicine : OAEM · 2020Article
- Automated urinalysis combining physicochemical analysis, on-board centrifugation, and digital imaging in one system: A multicenter performance evaluation of the cobas 6500 urine work area.Practical laboratory medicine · 2019Article
- Diagnosis of urinary tract infection in older persons in the emergency department: To pee or not to pee, that is the question.Emergency medicine Australasia : EMA · 2019Article
- No need for a urine culture in elderly hospitalized patients with a negative dipstick test result.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2018Article
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4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe sensitivity of the dipstick in elderly patients with a suspected urinary tract infection (UTI) is unclear because of the inclusion of patients with urine contamination or asymptomatic bacteriuria in previous studies.
methodsWe selected consecutive patients aged 65 years or older hospitalized in internal medicine departments with bacteremic UTI (same organism in blood and urine cultures) minimizing misclassifications. The false positive rate was determined in consecutive patients with negative culture results. A positive dipstick was a test result with a trace leukocyte esterase and/or nitrite positivity. Bacteriuria was the growth of at least 105 colony-forming units per milliliter of urine.
resultsOf 20,555 consecutive patients, 228 had a bacteremic UTI, and 4069 a negative culture result. The sensitivity of the dipstick was 96.9% (95% CI-93.7-98.6) with a false positive rate of 42.4% (95% CI, 41.0-43.8) in those with a negative culture result.
conclusionsIn elderly hospitalized patients with a bacteremic UTI, the dipstick urinalysis is highly sensitive, much higher than reported previously in studies of UTIs in the elderly. It is unclear whether the observed high sensitivity of the dipstick was due to the exclusion of patients with asymptomatic bacteriuria or to spectrum bias. Studies of the clinical utility/disutility of using a negative dipstick to rule out a urinary tract infection are warranted.
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