Diagnostic accuracy of rapid urine dipstick test to predict urinary tract infection among pregnant women in Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia

Demilie, Tazebew; Beyene, Getenet; Melaku, Selabat; Tsegaye, Wondewosen

doi:10.1186/1756-0500-7-481

Cited by 61 publications

(51 citation statements)

References 6 publications

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“…[16][17][18] The second predominant isolate was S. aureus 4 (28.5%) followed by Citrobacter spp 3 (21.4%) and Kebsiella spp 2 (14.28%). 5,19 Among the Gram negative isolates Escherichia coli showed 4 (80%) sensitivity to amikacin, ciprofloxacin and nitrofurantoin. cefotaxime and ceftazidime showed a sensitivity of 60%.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic bacteriuria among antenatal women attending a tertiary care hospital in Kanchipuram: evaluation of screening tests and antibiotic susceptibility pattern

et al. 2016

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INTRODUCTIONUrinary tract infections are a common health problem and are more common in women compared to men. 1 The altered physiological, anatomical and hormonal changes during Pregnancy makes the antenatal mother more prone for Urinary tract infection. Such infections can be either symptomatic or asymptomatic. The term asymptomatic bacteriuria (ASB) is used when a bacterial count of the same species over 10⁵/ ml in midstream clean catch specimen of urine is obtained on two occasions without symptoms of urinary tract infection.2 This is very ABSTRACTBackground: Asymptomatic bacteriuria (ASB) occurring in pregnant women can lead onto complications like acute pyelonephritis, hypertensive disease of pregnancy, premature delivery and intrauterine growth retardation if untreated. Methods:The present study aims to estimate the occurrence of asymptomatic bacteriuria in antenatal women and to study the antibiotic susceptibility pattern of the isolates. The Gram staining, pus cell count and culture was performed for 120 urine samples. Antibiotic susceptibility testing was done by Kirby Baeur disk diffusion method. MRSA (Methicillin resistant Staphylococcus aureus) and ESBL (Extended spectrum Beta Lactamases) producers were identified by Standard guidelines. The sensitivity, specificity, negative predictive values and positive predictive values of Gram staining and pus cell count was calculated. Results: Out of the 120 samples 14 (11.66%) were positive for asymptomatic bacteriuria. The Gram staining showed specificity and negative predictive value of 95.2% and 98.1% respectively. Pus cell count showed a specificity and negative predictive value of 96.29% and 98.11% respectively. Escherichia coli were the predominant species isolated 5 (35.7%). Among the gram negative bacteria, amikacin and nitrofurantoin showed a susceptibility of 90% and 80% each. All the staphylococcus aureus isolates showed 100% sensitivity for nitrofurantoin. Two Klebsiella spp and one Escherichia coli isolate were identified as ESBL producers. Among the S. aureus isolates 3 were identified as Methicillin resistant (MRSA). Conclusions: Urine culture should be performed for all pregnant women irrespective of the symptoms and should be treated promptly to prevent the complications arising out of ASB.

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Section: Discussionmentioning

confidence: 99%

Asymptomatic bacteriuria among antenatal women attending a tertiary care hospital in Kanchipuram: evaluation of screening tests and antibiotic susceptibility pattern

et al. 2016

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“…In some clinical settings such as with infants, leukocyte esterase (LE) and pyuria (by dipstick analysis) have a very high sensitivity and specificity for UTI (>90% as defined by the culture of a uropathogen from urine with >100,000 colony forming units (CFU) per ml) [2, 3]. However, in contexts such as pregnancy, dipstick analysis using LE, pyuria, or presence of nitrites is less reliable as an indication of UTI per the microbiological definition of 10 5 CFU/ml cutoff [4, 5]. While dipstick urinalysis that is positive for LE and/or nitrites in a clean-catch urine sample is consistent with a UTI diagnosis, these tests can miss UTIs that meet the gold standard of bacteriuria diagnosis in relation to adverse outcomes in pregnancy (e.g.…”

Section: Gram-positive and Polymicrobial Uti Epidemiologymentioning

confidence: 99%

Gram-Positive Uropathogens, Polymicrobial Urinary Tract Infection, and the Emerging Microbiota of the Urinary Tract

2016

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Gram-positive bacteria are a common cause of urinary tract infection (UTI), particularly among individuals who are elderly, pregnant, or who have other risk factors for UTI. Here we review the epidemiology, virulence mechanisms, and host response to the most frequently isolated Gram-positive uropathogens: Staphylococcus saprophyticus, Enterococcus faecalis, and Streptococcus agalactiae. We also review several emerging, rare, misclassified, and otherwise underreported Gram-positive pathogens of the urinary tract including Aerococcus, Corynebacterium, Actinobaculum, and Gardnerella. The literature strongly suggests that urologic diseases involving Gram-positive bacteria may be easily overlooked due to limited culture-based assays typically utilized for urine in hospital microbiology laboratories. Some UTIs are polymicrobial in nature, often involving one or more Gram-positive bacteria. We herein review the risk factors and recent evidence for mechanisms of bacterial synergy in experimental models of polymicrobial UTI. Recent experimental data has demonstrated that, despite being cleared quickly from the bladder, some Gram-positive bacteria can impact pathogenic outcomes of co-infecting organisms. When taken together, the available evidence argues that Gram-positive bacteria are important uropathogens in their own right, but that some can be easily overlooked because they are missed by routine diagnostic methods. Finally, a growing body of evidence demonstrates that a surprising variety of fastidious Gram-positive bacteria may either reside in or be regularly exposed to the urinary tract and further suggests that their presence is widespread among women, as well as men. Experimental studies in this area are needed; however, there is a growing appreciation that the composition of bacteria found in the bladder could be a potentially important determinant in urologic disease, including susceptibility to UTI.

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“…Early detection and treatment of UTIs is recommended and may help to reduce the incidences and its associated complications [4]. On other hand, inaccurate diagnosis of UTIs exposes patient to a wrong and unnecessary treatment [3,5]. There are several tests available for diagnosis of UTIs such as gram stain, dipstick, automated assay and urine culture remains [2].…”

Section: Introductionmentioning

confidence: 99%

“…There are several tests available for diagnosis of UTIs such as gram stain, dipstick, automated assay and urine culture remains [2]. Of all the tests urine culture remains to be the standard method for diagnosis of UTIs especially in low and middle-income countries [5].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of dipsticks test among clinically suspected urinary tract infected patients at National Hospital, Tanzania

Katunzi¹,

Bwire²,

Kalabashanga³

et al. 2019

Open J Bac

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Background: Dipstick test is a rapid test for diagnosis of urinary track infections (UTIs). Rapid test should be accurate so that does not give a lot of false results that may subject patients to wrong treatments especially when used alone. Therefore, this study was set to determine the diagnostic performance of dipsticks tests by comparing with a standard urine culture Methods: Microbiological investigations of urine samples suspected of UTIs were performed at Central Pathology laboratory, Muhimbili National Hospital, Dar es Salaam. Dipsticks tests (leucocyte esterase and nitrite) were immediately performed from the submitted urine samples. Both positive and negative samples by dipsticks were subjected to quantitative urine culture using cysteine lactose electrolyte defi cient agar (CLED). Diagnostic performance such as sensitivity, specifi city and predictive values were determined by cross tabulation using GraphPad prisms whereas the distributions of the culture-isolated bacteria were expressed in frequency and percentage. Type 1 error for signifi cance was 0.05. Results:Overall 300 urine samples were simultaneously tested for dipsticks and urine culture. Of 300 urine samples, 218 (73%) tested dipsticks positive while 134 (45%) had signifi cant culture growth. Of 134 culture positive samples, Escherichia coli were mostly isolated by 47.4% while Proteus species were less isolated by 3.8%. Staphylococcus saprophyticus were the most isolated gram-positive bacteria by 6.3%. The sensitivity, specifi city, positive and negative predictive values of dipsticks tests were 56%[95%CI (confi dence interval); 49%-62%)], 85%(95%CI; 76%-91%), 91%(95%CI; 85%-95%) and 42%(95%CI; 35% -50%) respectively. The diagnostic accuracy of dipsticks test was 1 (p = 0.1213). Conclusion:The study found a moderate accuracy of dipsticks tests. Almost half of the patients diagnosed with UTIs by dipsticks tests were not found infected by urine cultures. The study recommends that, in resource available settings, urine culture should be done to confi rm the dipsticks tests results.

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Diagnostic accuracy of rapid urine dipstick test to predict urinary tract infection among pregnant women in Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia

Cited by 61 publications

References 6 publications

Asymptomatic bacteriuria among antenatal women attending a tertiary care hospital in Kanchipuram: evaluation of screening tests and antibiotic susceptibility pattern

Asymptomatic bacteriuria among antenatal women attending a tertiary care hospital in Kanchipuram: evaluation of screening tests and antibiotic susceptibility pattern

Gram-Positive Uropathogens, Polymicrobial Urinary Tract Infection, and the Emerging Microbiota of the Urinary Tract

Diagnostic accuracy of dipsticks test among clinically suspected urinary tract infected patients at National Hospital, Tanzania

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