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Validity of the urine dipslide under daily practice conditions
Ron Winkens1, Hanny Nelissen-Arets, Ellen Stobberingh
1Transmural Care Unit Department of Medical Microbiology, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands. ron.winkens@hag.unimaas.nl
Background:
So far, the validity of urine dipslides has been studied only under optimal conditions, which may not reflect the situation in daily practice.
Objective:
We studied the validity of the urine dipslide as performed under daily practice conditions and assessed the influence of the incubation period (24 h versus 48 h) on validity.
Methods:
Fresh urine samples of patients with signs/symptoms of a possible urinary tract infection (UTI) were examined in general practice via a nitrite test, a urine sediment and a dipslide. A second dipslide was inoculated and sent to the hospital microbiology laboratory for culture. This culture acted as gold standard. We calculated the sensitivity and specificity of the tests performed.
Results:
Of the 273 patient episodes included, 62% had a UTI (166 of 268 cultures). The sensitivity of the dipslide performed in daily general practice was 73% and the specificity was 94%.
Conclusion:
The validity of the dipslide read under practice conditions is lower than under optimal conditions. Actions to improve performance are needed. Nonetheless, using the dipslide instead of the sediment as a second step after the nitrite test would improve the diagnostic work-up of UTI.