Vaginal leukocyte counts for predicting sexually transmitted infections in the emergency department

Sheele, Johnathan M.; Elkins, Justin M.; Mohseni, Michael; Monas, Jessica; Campos, Santiago Cantillo; Benard, Ronald B.; Mead-Harvey, Carolyn; Mi, Lanyu

doi:10.1016/j.ajem.2021.06.070

Cited by 3 publications

(5 citation statements)

References 35 publications

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“…Younger age, being single (compared to married/life partner), and having higher vaginal WBCs on the wet mount were significantly associated with receiving empiric antibiotics for gonorrhea and chlamydia, which have also been reported previously [ 24 , 27 , 29 , 37 , 38 ]. ED clinicians were more likely to empirically treat gonorrhea and chlamydia in the ED when trichomonas was identified during the ED encounter.…”

Section: Discussionsupporting

confidence: 77%

“…Vaginal wet mount clue cells, trichomonas, and yeast were either present or absent. Vaginal wet mount WBCs were categorized as ≤10 or 11–100 cells/HPF [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

“…Te data set contained retrospective data extracted from the electronic medical records by an institutional information technology team. Data from this data set have been published previously, including how the data set was created [19][20][21][22][23][24][25][26][27][28].…”

Section: Methodsmentioning

confidence: 99%

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Patient and Provider Demographics and the Management of Genitourinary Tract Infections in the Emergency Department

Sheele,

Mi,

Monas

et al. 2023

Emergency Medicine International

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Introduction. Urinary tract infections (UTIs) and sexually transmitted infections (STIs) can have overlapping signs, symptoms, and findings on urinalysis. Our objective was to determine if patient or provider demographics are associated with differences in the diagnosis and management of UTIs and STIs in the emergency department (ED). Methods. We analyzed 38,062 ED patient encounters from a single healthcare system between April 18, 2014, and March 7, 2017. All encounters were women ≥18 years of age and not admitted to the hospital. We performed logistic regression using patient and provider demographics, laboratory testing results, ED triage data, and ED diagnoses. Results. The patient’s age, race, and marital status were not associated with having an ED UTI diagnosis with a urine culture ≥10,000 colony forming units (CFUs)/mL (vs. <10,000 CFUs/mL). Patient race and the sex of the ED provider were not associated with differences in empiric antibiotic treatment for gonorrhea and chlamydia during the ED encounter. Patient’s race and the sex of the ED provider were also not associated with discordance between empiric antibiotic therapy given in the ED and the results of gonorrhea and chlamydia tests that resulted following the ED encounter. Conclusion. In our multivariate analyses, we did not observe that the patient’s race resulted in significant differences in the diagnosis of UTIs with bacteriuria ≥10,000 CFU/mL or differences in the empiric treatment of gonorrhea and chlamydia infections among those tested for the infection in the ED. The patient’s age and marital status, but not the provider’s sex, were significantly associated with differences in the management of gonorrhea and chlamydia.

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Section: Discussionsupporting

confidence: 77%

“…Vaginal wet mount clue cells, trichomonas, and yeast were either present or absent. Vaginal wet mount WBCs were categorized as ≤10 or 11–100 cells/HPF [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

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Patient and Provider Demographics and the Management of Genitourinary Tract Infections in the Emergency Department

Sheele,

Mi,

Monas

et al. 2023

Emergency Medicine International

Self Cite

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“…Data has previously been published from this dataset. 2,[15][16][17][18][19][20][21] The Mayo Clinic institutional review board provided an exemption from full review.…”

Section: Methodsmentioning

confidence: 99%

“…Vaginal wet preparation results can help risk-stratify ED patients for STIs. 2 Bacterial vaginosis (BV) is the most common cause of vaginitis in outpatient medicine and results when Mayo Clinic, Department of Emergency Medicine, Jacksonville, Florida Mayo Clinic, Division of Clinical Trials and Biostatistics, Phoenix, Arizona Mayo Clinic, Department of Emergency Medicine, Phoenix, Arizona Introduction: Clue cells result from aberrant vaginal microflora and are associated with an increased vaginal pH, which can allow colonization of uropathogens in the vaginal introitus, increasing the risk for urinary tract infections (UTI). We sought to determine whether clue cells on vaginal wet preparation in the emergency department (ED) are associated with emergency physician diagnoses of UTIs and positive urine cultures.…”

Section: Introductionmentioning

confidence: 99%

Clue Cells on Vaginal Wet Preparation Are Not Associated with Urinary Tract Infections or Positive Urine Cultures

Sheele

Mead-Harvey

Hodgson

2022

WestJEM

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Introduction: Clue cells result from aberrant vaginal microflora and are associated with an increased vaginal pH, which can allow colonization of uropathogens in the vaginal introitus, increasing the risk for urinary tract infections (UTI). We sought to determine whether clue cells on vaginal wet preparation in the emergency department (ED) are associated with emergency physician diagnoses of UTIs and positive urine cultures. Methods: We conducted a retrospective analysis examining a dataset of women (≥18 years of age) who received both a genital wet preparation and urine testing in the ED. Both chi-square and multivariable regression analysis were performed. Results: We analyzed 14,952 encounters. On both univariable and multivariable analyses, emergency physicians diagnosed significantly fewer clue cell-positive women with a UTI (10.9% diagnosed with UTI vs 13.1% without UTI) (P <.001). Women with clue cells on vaginal wet preparation were not more likely to have a positive urine culture or have a urine culture growing Escherichia coli. Pregnant women with clue cells on vaginal wet preparation were not more likely to have a UTI or have a positive urine culture. Conclusion: Emergency physicians diagnosed significantly fewer women with UTIs when they found clue cells on vaginal wet preparation. Clue cells on vaginal wet preparation were not associated with an increased likelihood of a positive urine culture or having E. coli growing in the urine.

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Spectrochip-based Calibration Curve Modeling (CCM) for Rapid and Accurate Multiple Analytes Quantification in Urinalysis

Ko,

Tadesse,

Kabiso

2024

Heliyon

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Vaginal leukocyte counts for predicting sexually transmitted infections in the emergency department

Cited by 3 publications

References 35 publications

Patient and Provider Demographics and the Management of Genitourinary Tract Infections in the Emergency Department

Patient and Provider Demographics and the Management of Genitourinary Tract Infections in the Emergency Department

Clue Cells on Vaginal Wet Preparation Are Not Associated with Urinary Tract Infections or Positive Urine Cultures

Spectrochip-based Calibration Curve Modeling (CCM) for Rapid and Accurate Multiple Analytes Quantification in Urinalysis

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