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Urine Analysis as a Reliable Indicator of a Urinary Tract Infection: A Cross-Sectional Study
Zaraq R Khan1, Zeeshan Ullah2, Adel Alwakeedi1
1Infectious Disease, University of Louisville Hospital, Louisville, USA.
Cureus
|February 9, 2026
Summary
A positive urine analysis does not always confirm a urinary tract infection (UTI). Relying solely on urine tests can lead to overdiagnosis and unnecessary antibiotic use, contributing to antibiotic resistance.
Area of Science:
- Urology
- Infectious Diseases
- Clinical Diagnostics
Background:
- Urinary tract infections (UTIs) are common, but definitive diagnostic criteria are lacking.
- This leads to overdiagnosis and overuse of antibiotics, fostering multi-drug resistant organisms.
Purpose of the Study:
- To assess the correlation between a positive urine analysis (≥10 white blood cells/high power field) and confirmed UTI.
- To evaluate the diagnostic accuracy of urine analysis in identifying true UTIs.
Main Methods:
- A cross-sectional retrospective study of 100 patients from the University of Louisville Healthcare network.
- Non-randomized consecutive sampling was employed.
- Data analyzed using SPSS v25 with descriptive statistics.
Main Results:
- Only 17% of patients met the operational definition of UTI, predominantly females.
- A significant portion (77%) of UTIs were asymptomatic.
- A positive urine analysis (≥10 WBC/HPF) did not consistently correlate with a confirmed UTI.
Conclusions:
- Urine analysis alone is an unreliable indicator of UTI.
- Hospital policies recommending reflex urine cultures based solely on positive urinalysis should be reconsidered.
- Discouraging routine reflex cultures can prevent overdiagnosis and reduce unnecessary antibiotic prescriptions.
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