Limited Usefulness of Urinary Dipsticks to Screen Out Catheter-associated Bacteriuria in ICU Patients

Abstract

The use of urinary dipsticks to screen out sterile urine specimens was investigated in catheterized fCU patients. During a three-month period, each urine sample quantitatively cultured was concurrently tested at the bedside with a dipstick. A total of 101 urine samples taken from 43 patients were analysed. Thirty-eight of them showed bacterial or yeast growths (incidence rate, 37%). The negative predictive value of the leukocyte esterase pad and/or the nitrate test pad to screen out sterile urine samples was 81%, indicating that dipsticks cannot routinely be proposed to select catheterized 1CU patients for quantitative culture of urine.

Paper and thread as media for the frugal detection of urinary tract infections (UTIs)

“…UTIs in particular have been extensively diagnosed using devices employing lateral flow assays. While earlier studies on urine dipsticks indicated optimistic results [ 99 ], subsequent studies demonstrated their limitations such as their general low sensitivity [ 20 , 100 ], and particular inaccuracies in cases of uncomplicated UTIs [ 101 ] and catheterized patients [ 102 ]. Similar results were found in a study of UTIs among pregnant women in Tanzania, where it was determined that the dipstick alone was not sufficiently reliable for accurate diagnosis [ 103 ].…”

“…Klebsiella spp., Staphylococcus aureus, staphylococci, Enterococcus spp., and Candida spp. Urine Colorimetric (dipstick) and cell culture – [ 102 ] Leukocyte esterase and nitrite Urine Colorimetric (dipstick) – [ 101 ] Leukocyte esterase, nitrite, blood trace Urine Colorimetric (dipstick) – [ 100 ] E. coli, Enterococcus spp., Klebsiella pneumoniae Acinetobacter spp., Pseudomonas spp., Morganella spp., S. aureus, Streptococci and Enterobacter spp. Urine Colorimetric (dipstick) and cell culture – [ 103 E. coli, Staphylococcus saprophyticus (monoclonal antibodies) Urine Colorimetric – [ 105 ] Schistosomes (worm circulating anodic antigen (CAA)) Urine 10 pg/mL to 0.03 pg/mL when increasing urine sample input from 10 μL to 7.5 mL [ 104 ] Enterobacter, Klebsiella, Acinetobacter (nitrate) Urine Colorimteric (dipstick) and cell culture – [ 108 ] P. mirabilis and other bacilli (proteins, ketones and nitrites) Urine Colorimetric (dipstick) and flow cytometry – [ 106 ] …”