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Screening for bacteriuria in patients with spinal cord lesion: dipstick test, microscopic examination and urine
K L Faarvang1, P Müller, B Lomberg
1Centre for Spinal Cord Injured, The Neuroscience Centre, Rigshospitalet, Copenhagen University Hospital, Hornbaek, Denmark.
Aim:
To investigate the positive and negative predictive values for bacteriuria of a rapid chemical dipstick procedure for leukocytes and nitrite, and a microscopic examination for leukocytes and bacteria with a urine culture being the reference in patients with spinal cord lesion (SCL).
Methods:
A prospective study. Significant bacteriuria was defined as > or = 10(5) CFU/mL. The microscopic examination for leukocytes was divided in four different cut-off limits for positive results.
Material:
A total of 256 consecutive early morning urine samples were collected from 143 SCL patients admitted to our in-patient facility.
Results:
One hundred and twenty-eight urine cultures revealed significant bacteriuria. Eighty-seven were infected by only one microorganism, 41 samples contained significant growth of more than one species. A total of 186 microorganisms in significant growth were identified.
Conclusion:
Three or more leukocytes should be considered as a positive result. The dipstick and microscopy tests are equally valuable, considering the single tests as well as the combinations evaluated.