Sensitivity of the dipstick in detecting bacteremic urinary tract infections in elderly hospitalized patients

PloS One
Zvi ShimoniPaul Froom

Abstract

The sensitivity of the dipstick in elderly patients with a suspected urinary tract infection (UTI) is unclear because of the inclusion of patients with urine contamination or asymptomatic bacteriuria in previous studies. We selected consecutive patients aged 65 years or older hospitalized in internal medicine departments with bacteremic UTI (same organism in blood and urine cultures) minimizing misclassifications. The false positive rate was determined in consecutive patients with negative culture results. A positive dipstick was a test result with a trace leukocyte esterase and/or nitrite positivity. Bacteriuria was the growth of at least 105 colony-forming units per milliliter of urine. Of 20,555 consecutive patients, 228 had a bacteremic UTI, and 4069 a negative culture result. The sensitivity of the dipstick was 96.9% (95% CI-93.7-98.6) with a false positive rate of 42.4% (95% CI, 41.0-43.8) in those with a negative culture result. In elderly hospitalized patients with a bacteremic UTI, the dipstick urinalysis is highly sensitive, much higher than reported previously in studies of UTIs in the elderly. It is unclear whether the observed high sensitivity of the dipstick was due to the exclusion of patients with asymptomatic b...Continue Reading

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Feb 18, 2012·American Journal of Clinical Pathology·Paul Froom, Mira Barak
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Oct 18, 2015·The Urologic Clinics of North America·Keri DetweilerSophie G Fletcher

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Citations

Apr 26, 2020·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Tony ZitekLiuba Santos
May 20, 2018·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Zvi ShimoniPaul Froom
Nov 24, 2021·Journal of Evaluation in Clinical Practice·Zvi ShimoniJochanan Benbassat
Jan 23, 2022·Nature Reviews. Urology·Savas Tasoglu
Apr 26, 2020·American Journal of Infection Control·Zvi ShimoniPaul Froom

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