ArticleScandinavian journal of primary health care2019
Sampling of urine for diagnosing urinary tract infection in general practice - First-void or mid-stream urine?
Article in Scandinavian journal of primary health care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Point-of-care tests for urinary tract infections to reduce antimicrobial resistance: a systematic review and conceptual economic model.Health technology assessment (Winchester, England) · 2024Pooled it
- Experiences of urine collection devices during suspected urinary tract infections: a qualitative study in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Trial
- Urine collection devices to reduce contamination in urine samples for diagnosis of uncomplicated UTI: a single-blind randomised controlled trial in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Trial
- Diagnostic tests for urinary tract infections and antimicrobial resistance-a reality check between diagnostic innovation and implementation: a critical narrative review.Frontiers in cellular and infection microbiology · 2026Review
- The Effects of Diet, Dietary Supplements, Drugs and Exercise on Physical, Diagnostic Values of Urine Characteristics.Nutrients · 2024Review
- Comprehensive insights into UTIs: from pathophysiology to precision diagnosis and management.Frontiers in cellular and infection microbiology · 2024Review
- Midstream versus first-void urine samples.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Impact of Male Patient Information on Quality of Urine Examination (PIQUE Study).Urologia internationalis · 2022Article
- Discrepancy in results between dipstick urinalysis and urine sediment microscopy.Experimental and therapeutic medicine · 2021Article
- Reducing infant catheterization in the emergency department through clean-catch urine collection.Journal of the American College of Emergency Physicians open · 2020Article
- Sniffing Out Urinary Tract Infection-Diagnosis Based on Volatile Organic Compounds and Smell Profile.Biosensors · 2020Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo study 1) whether the accuracy of point-of-care (POC) urine tests (dipstick, phase-contrast microscopy and culture) differs when performed on first-void urine (FVU) compared to mid-stream urine (MSU), and 2) if a delay of analysis up to four hours affects the accuracy of POC tests when performed on urine from symptomatic of urinary tract infection (UTI), non-pregnant women in general practice.
designProspective diagnostic study using paired samples. Setting/Intervention: Three general practices in Copenhagen. Each woman delivered FVU and MSU samples from the same void. As a reference standard, 8 ml of MSU was sent for culture at the Microbiology Department. PATIENTS: 117 women with one or more symptoms of UTI.
main outcome measuresSensitivity, specificity and agreement with the reference standard of FVU and MSU with different time delays (zero vs. one vs. four hours) as compared to reference standard (MSU at time zero in boric acid tubes).
resultsAll three POC tests performed on MSU were significantly more in agreement with the reference than when performed on FVU when analysis was done immediately. The error rate was 16% for MSU vs. 23% for FVU with POC culture, 27% vs. 40% with microscopy and 25% vs. 33% with dipstick testing. Delay of analysis up to four hours did not decrease agreement with the reference. Conclusion/Implication: MSU samples should be used in general practice for optimal accuracy of POC tests. Analysis can be delayed up to four hours. Key points Point-of-care tests (dipstick testing, microscopy and culture) for diagnosing urinary tract infection performed on mid-stream urine samples are significantly more accurate than when performed on first-void urine samples. Delay of analysis up to four hours did not decrease the accuracy of any of the point-of-care tests. Point-of-care culture was more accurate than dipstick and microscopy both when performed on mid-stream urine and first-void urine The main contaminant in first-void urine samples was Enterococci spp., which contributed to the majority of false positives.
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Registered trials
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