Rapid diagnostic methods as predictors of urinary infection in primary health care
Pallarés, J.; Casas, J.; Guarga, A.; Marquet, R.; Grifell, E.; Juvé, R.; Castelltort, R.
Medicina Clinica 91(20): 775-778
1988
ISSN/ISBN: 0025-7753 PMID: 3070187 Document Number: 326343
The diagnostic efficaciousness of rapid performance and reading biochemical tests (reactive strip with nitrites and leukocyte-esterase tests) against some classic techniques (Gram stain, urinary sediment) were evaluated. There were 180 patients, 144 women (80%) and 36 ment (20%), who presented with dysuria. Ninety eight positive urine cultures (> 100 000 cfu/ml) were obtained. Gram sensitivity and specificity were 93 and 94%; urine culture sensitivity and specificity were 49 and 94%, nitrites test sensitivity and specifity were 51 and 95%, and those of leukocyte esterase test were 85 and 97%, sensitivity ans specificity of combined nitrites-leukocyte esterase tests were 93 and 91%, respectively. The positive predictive value was, by the same order, 95, 90, 92, 97, and 93%. When urine sediment (> 10 leukocytes per field) was compared with reactive strip (leukocyte esterase or nitrites), the latter revealed as more efficacious than the former, with as statistically significant difference (p < 0.0001). We concludee that, in our milieu, postiveness of nitrites test or leukocyte esterase test provide better overall results. Rapidity in performance, low cost, and good results of parameters which determine test power covert them into advisable methods for detecting significant bacteriuria in symptomatic patients attending at primary health care units.