Validation of a method for the rapid diagnosis of urinary tract infection suitable for use in general practice

A combination of reagent strip testing and examining urine appearance can be used to screen out noninfected cases before urine specimens are sent to the laboratory. A validation of this method was carried out in a microbiology laboratory using 970 specimens received over a three-week period. When the tests for nitrite, blood and protein on N-Multistix reagent strips (Ames) were all negative in a clear urine then the predictive value for the absence of bacteriuria was 98.5%. Positive strip tests in a turbid urine detected 80.1% of infections. On the basis of these findings it is recommended that general practitioners test the urine samples of all patients with suspected urinary tract infections by this method and only send to the laboratory those specimens with positive findings. Using this method the routine laboratory workload involved in testing urine specimens would be reduced by 40%, instant results would be available in the general practitioner's surgery and the patient would receive immediate and appropriate treatment.