Urinary Squamous Epithelial Cells Do Not Accurately Predict Urine Culture Contamination, but May Predict Urinalysis Performance in Predicting Bacteriuria

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Nicholas M MohrBrett Faine

Abstract

The presence of squamous epithelial cells (SECs) has been advocated to identify urinary contamination despite a paucity of evidence supporting this practice. We sought to determine the value of using quantitative SECs as a predictor of urinalysis contamination. Retrospective cross-sectional study of adults (≥18 years old) presenting to a tertiary academic medical center who had urinalysis with microscopy and urine culture performed. Patients with missing or implausible demographic data were excluded (2.5% of total sample). The primary analysis aimed to determine an SEC threshold that predicted urine culture contamination using receiver operating characteristics (ROC) curve analysis. The a priori secondary analysis explored how demographic variables (age, sex, body mass index) may modify the SEC test performance and whether SECs impacted traditional urinalysis indicators of bacteriuria. A total of 19,328 records were included. ROC curve analysis demonstrated that SEC count was a poor predictor of urine culture contamination (area under the ROC curve = 0.680, 95% confidence interval [CI] = 0.671 to 0.689). In secondary analysis, the positive likelihood ratio (LR+) of predicting bacteriuria via urinalysis among noncontaminated spe...Continue Reading

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Citations

Jun 14, 2017·The Pharmacogenomics Journal·J GraesslerS R Bornstein
May 1, 2019·Annals of Laboratory Medicine·Victoria Ortiz de la TablaFélix Gutiérrez
Jan 3, 2018·Pediatrics in Review·Eric Balighian, Michael Burke
Feb 8, 2021·Clinica Chimica Acta; International Journal of Clinical Chemistry·Timo KouriAnu Pätäri-Sampo

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