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Related Experiment Videos

Three techniques compared for detecting bacteriuria in symptomatic patients.

D L Warkentin, R A Rawling, W E Koppel

    Clinical Chemistry
    |August 1, 1985
    PubMed
    Summary
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    Microscopic urine evaluation is comparable to biochemical (Chemstrip-9) and staining (Bac-T-Screen) methods for detecting infections. However, these methods miss positive urine cultures, so routine urine culturing for symptomatic patients remains essential.

    Area of Science:

    • Clinical Microbiology
    • Urinalysis
    • Diagnostic Testing

    Background:

    • Urinary tract infections (UTIs) are common, necessitating accurate and efficient diagnostic methods.
    • Microscopic examination of urinary sediment is a traditional method for UTI diagnosis.
    • Alternative methods like biochemical tests and colorimetric staining aim to streamline urinalysis.

    Purpose of the Study:

    • To compare the diagnostic accuracy of microscopic urinalysis with biochemical (Chemstrip-9) and colorimetric (Bac-T-Screen) methods.
    • To evaluate the feasibility of omitting urine cultures in favor of these alternative tests.
    • To assess the sensitivity and specificity of each method in symptomatic patients.

    Main Methods:

    • Three separate studies were conducted on symptomatic patients.

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  • Urine samples were analyzed using microscopy, Chemstrip-9 (leukocyte esterase activity), and Bac-T-Screen.
  • Urine cultures were performed, with positive results defined by specific colony counts for catheterized and non-catheterized patients.

    • Main Results:

    • The sensitivity of Chemstrip-9 showed a progressive decline across the studies.
    • Bac-T-Screen sensitivity varied between the two studies where it was used.
    • Microscopy, Chemstrip-9, and Bac-T-Screen demonstrated comparable sensitivity and specificity.
    • 13-36% of positive urine cultures would be missed by the alternative methods.

    Conclusions:

    • Biochemical and colorimetric methods are not consistently more sensitive or predictive than urine microscopy for diagnosing UTIs.
    • Omitting urine cultures based solely on these alternative tests risks missing a significant percentage of infections.
    • Routine urine culturing remains crucial for symptomatic patients to ensure accurate diagnosis and appropriate treatment.