Predicting bacteriuria in urogynecology patients

• Published in: American journal of obstetrics and gynecology Vol. 192; no. 5; pp. 1376 - 1378
• Main Authors: Rahn, David D., Boreham, Muriel K., Allen, Katrina E., Nihira, Mikio A., Schaffer, Joseph I.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Mosby, Inc 01-05-2005; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Bacterial diseases; Bacterial diseases of the urinary system; Bacteriuria; Bacteriuria - diagnosis; Bacteriuria - epidemiology; Bacteriuria - etiology; Biological and medical sciences; Carboxylic Ester Hydrolases - blood; Diagnosis, Differential; Female; Genital Diseases, Female - urine; Gynecology. Andrology. Obstetrics; Hematuria - diagnosis; Human bacterial diseases; Humans; Infectious diseases; Medical sciences; Middle Aged; Nitrite; Nitrites - urine; Predictive Value of Tests; Prevalence; Reagent strip; Reagent Strips - standards; Sensitivity and Specificity; Urinalysis; Urine culture; Urologic Diseases - urine; Nitrite; Urinalysis; Bacteriuria; Reagent strip; Urine culture; Human; Gynecology; Nitrites; Patient; Urinalysis Bacteriuria Nitrite Reagent strip Urine culture; Predictive factor; Obstetrics; Urology
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2004.12.041

This study was undertaken to determine whether reagent strip testing can predict bacteriuria in urogynecology patients.
All women undergoing urodynamic evaluations from June 1997 to October 2001 were identified by using a computerized database. Urine culture results were compared with reagent strip testing. Significant bacteriuria was defined as greater than 10
5 colony-forming units per milliliter.
Bacteriuria prevalence was 8.6% (n
=
51). Sensitivity and specificity of nitrites were 0.51, (95% CI, 0.31-0.66) and 0.991, (95% CI, 0.974-0.998), respectively. Blood had a lower sensitivity (0.35, 95% CI, 0.20-0.54) and specificity (0.80, 95% CI, 0.75-0.84). Leukocyte esterase was similar to blood with a sensitivity of 0.28 (95% CI, 0.14-0.45) and specificity of 0.83 (95% CI, 0.78-0.87). No combination of tests offered improved sensitivity or specificity over nitrites alone.
Nitrite dipstick testing has excellent specificity for bacteriuria in urogynecologic patients. These results support the treatment of women with positive nitrites who are preparing to undergo urodynamics without obtaining culture.