[Guidelines for diagnosing urinary tract infections: advantages and disadvantages of various methods]

The revised guidelines on urinary tract infections from the Dutch Institute for Healthcare Improvement (CBO) and those from the Dutch College of General Practitioners (NHG), both published in 1999, differ concerning how these infections can best be diagnosed. In the case of a negative nitrite test result, the Institute advises to count the number of leucocytes or bacteria using a microscope, whilst the College advocates just counting the number of bacteria using a microscope or assessing bacterial growth by using a dip-slide. The difference may be explained by the diagnostic criterion for the numbers of colony forming units per millilitre of cultured urine. Leucocyturia with a typical history of acute dysuria and frequent voiding might indeed be sufficient as a diagnostic tool. However, it is questionable whether this is true in daily practice, where many patients with less typical complaints are encountered.