Observational studyBMJ evidence-based medicine2025
Diagnostic accuracy of dipsticks for urinary tract infections in acutely hospitalised patients: a prospective population-based observational cohort study.
Observational study in BMJ evidence-based medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- An observational diagnostic accuracy study comparing the urine dipstick with a consensus-based reference standard for the diagnosis of urinary tract infections in older adults.BMC geriatrics · 2026Observational
- Impact of PA-100 AST System Rapid Antibiotic Susceptibility Test on Antibiotic Prescription for Community-Acquired Urinary Tract Infections in Spanish Primary Care Settings.Antibiotics (Basel, Switzerland) · 2026Article
- Urine volatile organic compounds profiling via GC-IMS combined with machine learning: a powerful diagnostic and pathogen differentiation tool for urinary tract infections.Frontiers in cellular and infection microbiology · 2026Article
- Evaluation of diagnostic accuracy using routine laboratory parameters.Bioinformation · 2026Article
- AI-based clinical prediction model for early infectious disease classification in the emergency department.Frontiers in artificial intelligence · 2026Article
- Study on the diagnostic efficacy of the computerized tomography attenuation value of renal pelvis urine in true bacteriuria secondary to renal and ureteral stones.Renal failure · 2025Article
- Performance of Gram Stain, Leukocyte Esterase, and Nitrite in Predicting the Presence of Urinary Tract Infections: A Diagnostic Accuracy Study.Archives of academic emergency medicine · 2025Article
- Comparison of Urine Dipstick and Urine Sediment Microscopy With Culture for Diagnosing Pediatric Urinary Tract Infections: A Retrospective Cross-Sectional Study at Tikur Anbessa Hospital, Ethiopia.International journal of pediatrics · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the added diagnostic value of dipsticks for urinary tract infections (UTI) in acutely hospitalised individuals.
designProspective population-based cohort study.
settingNorth Denmark.
participantsAll adults (≥18 years) examined with dipsticks at emergency departments in North Denmark Region from September 20 through 23 October 2021.
main outcome measuresUTI was defined as ≥1 symptom of new-onset frequency, dysuria or suprapubic tenderness combined with a positive urine culture. Positive dipsticks were defined as any reaction for leucocyte esterase and/or nitrite.
resultsDipsticks were used in 1052/2495 (42%) of acutely hospitalised patients with a median age of 73 years (IQR 57-82) and 540 (51%) were female. Overall, 89/1052 (8%) fulfilled the UTI criteria and urine cultures were done in 607/1052 (58%) patients. Among patients examined with both dipstick and urine culture, sensitivity and specificity for UTI were 87% (95% CI 78% to 93%) and 45% (95% CI 41% to 50%). Positive and negative predictive values were 21% (95% CI 17% to 26%) and 95% (95% CI 92% to 98%), whereas positive and negative likelihood ratios were 1.58 (95% CI 1.41 to 1.77) and 0.30 (95% CI 0.18 to 0.51). Pretest probabilities of UTI ranged from 29% to 60% in participants with specific UTI symptoms with corresponding post-test probabilities of 35-69% if dipsticks were positive and 12-27% if dipsticks were negative. Results remained comparable if final clinical diagnosis was used as outcome among all patients examined with dipsticks. Modified Poisson regression yielded an adjusted relative risk of 4.41 (95% CI 2.40 to 8.11) for empirical antibiotics for UTI in participants without specific UTI symptoms and a positive dipstick.
conclusionsDipsticks yielded limited clinical decision support compared with a symptom-driven approach in this study and were independently associated with excess antibiotics for UTI.
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