Utility of urinary gram stain as a diagnostic method for urinary tract infection

Abstract

INTRODUCTIONUrinary tract infection (UTI) is a common health problem. Most of the times, clinical findings of UTI are subtle and non-specific and present with fever only. However, UTI can pose serious complications like septicemia, renal abscesses etc.Hence, timely and accurate diagnosis of UTI is pertinent. Microscopic urinary sediment analysis, urine culture, dipstick analysis are the common methodologies used to detect UTI. Recently, even flow cytometry, renal or bladder ultrasound, cystourethrogram were also utilized for diagnosis of UTI.1,2 However, since decades urine culture has been the gold standard for detection of UTI. 1,3,4 Above cited techniques are time consuming and expensive. There are several studies in which urinary gram stain was utilized for UTI detection. [3][4][5][6] In the present study, we evaluated the efficiency of urinary gram stain for detection of UTI using urine culture as gold standard. METHODSThe midstream urine specimen was collected in sterilized tubes from male (55 cases) and female patients (45 cases) in the age group of 20-50years with clinical symptoms suggesting UTI. All the urine samples were processed by centrifugation at 3000rpm for 15minutes. Centrifuged samples were submitted for urine microscopy, urinary gram stain and urine culture. The patients receiving ABSTRACTBackground: Urinary tract infection (UTI) is one of the most common infections in humans. Timely diagnosis and treatment are necessary to reduce the complications from UTI. Urine culture is still the gold standard diagnostic test for UTI, however it is costly and time consuming. The present study was conducted to compare the utility of urinary gram stain, microscopy of centrifuged urine sample and urine culture for the diagnosis of UTI. Methods: 100 urine samples were processed for gram stain, culture and microscopy. Urinary gram stain findings were correlated with microscopy and culture results. Using urine culture as gold standard, the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of urinary gram stain were assessed for the diagnosis of UTI. Results: The accuracy of urinary gram stain for detection of UTI was 97%. Conclusions: Urinary gram stain is a reliable diagnostic test for early detection of UTI.

Utility of Screening Test in Early Diagnosis of Urinary Tract Infection in Children

“…The urine Gram stain, has been proposed both as a more sensitive and specific method for identifying patients with UTI, especially as a screening test when compared with culture (Mustafa et al, 2008). But in our study, sensitivity was 84.61% which is similar to the finding of (Mustafa et al, 2008) and specificity of Gram stain 85.71 % which was comparable to results noted by (Anchinmane et al, 2018).…”

Point-of-Care Urine Gram Stain for Managing Febrile Urinary Tract Infection in Adults

“…Unlike previous studies on urine Gram staining in a laboratory [3,6,[16][17][18][19], this observational study investigated the utility of urine PCGS in estimating etiologic agents and choosing narrower-spectrum antimicrobials to treat fUTI in adults. Our results yielded three main ndings.…”