Pinnacle Biochemistry Research

March 2014, Vol.1 (1).

© Author(s) 2014. This work is distributed under the Creative Commons Attribution 3.0 License.

Research Article

 

Risk associated with dipstick urinalysis for diagnosing urinary tract infection

Tamirys Schulz1*, Marcos José Machado2, Arício Treitinger2, Alexandre Fiamoncini3 & Lorena Mares de Oliveira Niederauer3

1*Master´s degree student at the Post-Graduation Program in Pharmacy
Universidade Federal de Santa Catarina

Florianópolis, SC, Brazil.

2Professor Dr. at the Health Sciences Center

Department of Clinical Analysis

Universidade Federal de Santa Catarina

Florianópolis, SC, Brazil.

3Pharmacist at the Laboratory of Clinical Analysis

University Hospital

Universidade Federal de Santa Catarina

Florianópolis, SC, Brazil.

Accepted 19 February, 2014; Available Online 9 March, 2014

Abstract:

Urinary tract infections (UTIs) are highly prevalent in the Brazilian population. Rapid tests, such as the urinalysis reagent strip and/or microscopy, guide the early diagnosis of UTIs and determine the performance of urine cultures. The objective of this work was to evaluate the sensitivity, specificity and diagnostic accuracy of urinalysis by dipstick tests and compare with microscopic examination and culture and sensitivity of urine. A total of 400 patients participated in this study, which included medical requests for urinalysis strip reagents, microscopy and urine cultures. Random 50-ml samples were obtained at least two hours after the last urination; midstream urine samples were obtained after the participant had performed personal hygiene. The specificities were nitrite 99.7%, leukocyte esterase 85.2%, leukocyturia 78.2%, bacteriuria 96.6%, bacterioscopy 96.6%, and urinalysis 63.9%, with sensitivities of 27.9%, 44.2%, 76.7%, 81.4%, 81.4 and 97.7%, respectively; the area under the curve (AUCs) were 0.638, 0.647, 0.774, 0.890, 0.890 and 0.808, respectively, and the urine culture was considered the gold standard. Comparing the bacteriuria and bacterioscopy of all of the studied tests and parameters, the accuracy was below P <0.01.

Keywords: Diagnostic accuracy; reagent strips; urinalysis; urinary tract infections.
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