Urine Screening Strategy Employing Dipstick Analysis and Selective Culture: An Evaluation

Loo, Stanley Y. T.; Scottolini, A G; Luangphinith, Somkeng; Adam, Audrey L.; Jacobs, Lee D.; Mariani, Albert J.

doi:10.1093/ajcp/81.5.634

Cited by 33 publications

(11 citation statements)

References 0 publications

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“…The initial problem of specimens clogging the filter has been solved by increasing the vacuum force which causes the entire specimen to be pulled through the filter card. The Bac-T-Screen is a sensitive screening test (98%) for detecting clinically significant bacteriuria (49). When compared with the clinical classification of infection rather than quantitative urine cultures, the sensitivity of the Bac-T-Screen was higher than that of the culture method at 2105 CFU/ml, 98 and 45%, respectively.…”

Section: Colorimetric Filtrationmentioning

confidence: 99%

“…Loo and associates used the Chemstrip-9 (Bio-Dynamics) to determine the urine specimen workup (49). If (69).…”

Section: Laboratory Approach To Screeningmentioning

confidence: 99%

“…Some investigators have demonstrated a cost savings by using the Chemstrip LN to determine the need for culturing urine specimens (5,49,56). With this approach, Marsik and associates evaluated urine specimens from pediatric and adolescent patients and estimated a $5,000/year savings to the laboratory and a $10,000/year savings to the patient (56).…”

Section: Laboratory Approach To Screeningmentioning

confidence: 99%

“…Bartlett et al reported an 18% reduction in total cost and a 19% reduction in labor cost when specimens were screened by the Chemstrip LN and cultured only when LN screens were positive (5). Loo and associates reported a cost savings to the laboratory of approximately $32,000 when they used the urinalysis test strategy, i.e., a screening dipstick analysis with sediment microscopy performed on urine samples positive for leukocyte esterase, nitrite, protein, or blood (49).…”

Section: Laboratory Approach To Screeningmentioning

confidence: 99%

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Detection of urinary tract infections by rapid methods

Pezzlo

1988

Clin Microbiol Rev

121

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A review of rapid urine screens for detection of bacteriuria and pyuria demonstrates a number of available alternatives to the culture method. Selection of one or more of these systems for routine use is dependent upon the laboratory and the patient population being tested. The laboratory approach to the diagnosis of urinary tract infection should consider the clinical diagnosis of the patient whenever possible. Keeping in mind that quantitative urine cultures alone cannot be used to detect infection in some patient populations unless lower colony counts are considered, a rapid screen may be a more practical approach. It has become accepted that 10(5) CFU/ml can no longer be used as the standard for all patient groups, that pyuria often is important in making the diagnosis of a urinary tract infection, and that most of the rapid screens are more sensitive than the culture method at 10(5) CFU/ml. Presently, no one approach can be recommended for all laboratories and all patient groups. However, each diagnostic laboratory should select one approach which is best for its situation. It is not practical, efficient, or cost effective to define a protocol for each possible clinical condition; however, all should be considered when developing a protocol. This protocol should be compatible with the patient population and communicated to the physicians. Use of a rapid screen should be beneficial to the patient, the physician, and the laboratory.

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Section: Colorimetric Filtrationmentioning

confidence: 99%

“…Loo and associates used the Chemstrip-9 (Bio-Dynamics) to determine the urine specimen workup (49). If (69).…”

Section: Laboratory Approach To Screeningmentioning

confidence: 99%

Section: Laboratory Approach To Screeningmentioning

confidence: 99%

Section: Laboratory Approach To Screeningmentioning

confidence: 99%

See 2 more Smart Citations

Detection of urinary tract infections by rapid methods

Pezzlo

1988

Clin Microbiol Rev

121

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“…In others, special care was taken, such s the use of sterilized Containers and collection of clean voided, midstream or catheter urine (5,7,12,13,14,22).…”

Section: Discussionmentioning

confidence: 99%

Screening Urine Specimen Populations for Normality Using Different Dipsticks: Evaluation of Parameters Influencing Sensitivity and Specificity

Bank¹,

Codrington²,

Dieijen-Visser³

et al. 1987

Clinical Chemistry and Laboratory Medicine

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Summary:The reagent test strip Combur-9 Test-RL (Boehringer Mannheim) and the 8-SG Multistix (Ames) were simultaneously evaluated äs a rapid method for screening urines for normality.Differences between the two methods are for a considerable part determined by adjustment of the lowest detection limits of the leukocyte and erythrocyte dipstick fields.Patient populations (243 specimens presented to the routine laboratory and 230 specimens submitted for microbiological culture), Sediment analysis (routine or standardized) and composition of the screening protocol strongly influence values obtained for the sensitivity, specificity and predictive values, whereas use of a different dipstick is of minor importance on the final results.Higher sensitivity and specificity are observed when relating positive dipstick screening to positive culture than when relating positive standardized sediment to positive culture. Evaluation of dipstick method, using microscopic sediment analysis äs a reference parameter appears to be very dependent on the quality of the latter, which is therefore relatively unsuitable for this purpose. Apart from standardization, additional clinically significant findings are obtained using dipstick screening.

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Dipstick urinalysis screening of asymptomatic adults for urinary tract disorders. II. Bacteriuria

Pels

Bor

Woolhandler

et al. 1989

JAMA: The Journal of the American Medical Association

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Using criteria adopted by the US Preventive Services Task Force, we evaluated use of the dipstick urinalysis to screen for bacteriuria. When the leukocyte esterase and nitrite dipstick tests are combined, the positive predictive value for detecting bacteriuria exceeded 12% in groups with a 5% or higher prevalence of bacteriuria: women who are pregnant, diabetic, or over 60 years of age and all institutionalized elderly. Conventional antimicrobial regimens for asymptomatic bacteriuria have proved efficacious only for pregnant women. We conclude that pregnant women should be screened for bacteriuria, but with the more sensitive urine culture, because treatment prevents serious fetal and maternal sequelae. Dipstick screening may be justified in women who are over 60 years of age or diabetic. The prevalence of bacteriuria in other groups is too low to justify screening.

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Urine Screening Strategy Employing Dipstick Analysis and Selective Culture: An Evaluation

Cited by 33 publications

References 0 publications

Detection of urinary tract infections by rapid methods

Detection of urinary tract infections by rapid methods

Screening Urine Specimen Populations for Normality Using Different Dipsticks: Evaluation of Parameters Influencing Sensitivity and Specificity

Dipstick urinalysis screening of asymptomatic adults for urinary tract disorders. II. Bacteriuria

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