scholarly journals Macroscopy and Microscopy Urinalysis: A Vital Screening Procedure for Urinary Tract Infections (UTIs) in a Hospital in Awka, Nigeria

2020 ◽  
Vol 11 (1) ◽  
pp. 143
Author(s):  
Uchechukwu G. Nwankwo ◽  
Chinenye U. Ezebialu ◽  
Joachim O. Ezeadila ◽  
Ikechukwu Okoli
Keyword(s):  
Urinary Tract ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Urine Culture ◽  
Positive Urine ◽  
Microscopic Features ◽  
Tract Infections ◽  
Sensitivity Specificity ◽  
Urine Microscopy ◽  
Urine Colour

Urine examination has been employed in clinical practice as the most common screening laboratory method for early detection of urinary tract infections (UTIs) or renal disorder. This study was undertaken to ascertain the usefulness of urine macroscopy and microscopy as vital screening procedure for diagnosing UTI among antenatal patients in a teaching hospital in Awka, Nigeria. Freshly voided midstream urine specimens of 269 pregnant women were collected and examined using macroscopic, microscopic and culture methods. The sensitivity, specificity, positive predictive value and negative predictive value of urine colour, and microscopic features were compared with urine culture in diagnosis of UTI. Statistical analysis was done using SPSS and Epi info® and P-value was set at <0.05 significant level. One hundred and seven specimens showed positive urine cultures. Out of these 107 specimens, 60 (56.1%) also had deviation from normal urine colour and 77(72%) were positive on urine microscopy. Macroscopic examination showed that a significant relationship exists between urine colour and positive urine culture (p=0.0001). The sensitivity and specificity of urine colour with respect to UTI were 56.7% and 67.9% respectively. Urine microscopy revealed that the positive features had a significant relationship with positive urine culture (p= 0.000). Pyuria alone showed the specificity and positive predictive value of 100% each. The sensitivity, specificity, positive predictive value and the negative predictive value of combination of positive microscopic features were 72%, 64.8%, 57.5% and 77.8% respectively. Examination of colours and microscopic features of urine are therefore vital in predicting urinary tract infection.

scholarly journals Detection of Pyuria by Microscopic Urinalysis as a Marker of Pediatric Urinary Tract Infection

2019 ◽  
Vol 7 (1) ◽  
pp. 15-20
Author(s):  
Dhiraj Shrestha ◽  
Pratigya Thapa ◽  
Dinesh Bhandari ◽  
Balkrishna Bhattachan ◽  
Hiramani Parajuli ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Urine Culture ◽  
Clinical Practices ◽  
Wet Mount ◽  
Sensitivity Specificity

Globally, different diagnostic tests of urinary tract infection (UTI) are in clinical practices. A reliable test can increase the efficiency of the healthcare system, especially in a developing country like Nepal, reducing cost and time. Thus, we accessed the possibility of pyuria detected by microscopic urinalysis as a marker of pediatric UTI. The prospective study was conducted fromJuly2014 to January 2015 at Alka hospital, Lalitpur. Microscopic urinalysis of 353clean-catch urine samples was done by the wet mount method, followed by urine culture by a semi-quantitative method. We confirmed 64 (18.1%) UTI cases by culture, the gold standard for UTI diagnosis. Fever was the most common clinical manifestation in UTI cases. The sensitivity, specificity, positive predictive value and negative predictive value of pyuria detected by microscopic urinalysis to identify UTI were 50%, 70.9%, 27.6% and 86.5% respectively. In 318 febrile cases, the sensitivity, specificity, positive predictive value and negative predictive value of pyuria detected by microscopic urinalysis to identify UTI were 73.2%, 72.6%, 28.3% and 94.8% respectively. The findings suggest pyuria detected by microscopic urinalysis as not a worth while marker of pediatric UTI. But it is a trust worthy marker in febrile pediatric cases.

URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
University Hospital ◽  
E Coli ◽  
Positive Urine ◽  
Tract Infections

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

Culturing practices and the care of the urinary catheter in reducing NHSN-defined catheter-associated urinary tract infections: The tale of two teaching hospitals

2018 ◽  
Vol 39 (12) ◽  
pp. 1494-1496 ◽  
Author(s):  
Ana Cecilia Bardossy ◽  
Takiah Williams ◽  
Karen Jones ◽  
Susan Szpunar ◽  
Marcus Zervos ◽  
...  
Keyword(s):  
Intensive Care ◽  
Urinary Tract ◽  
Intensive Care Units ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Urinary Catheter ◽  
Teaching Hospitals ◽  
Positive Urine ◽  
Tract Infections ◽  
Catheter Care

AbstractWe compared interventions to improve urinary catheter care and urine culturing in adult intensive care units of 2 teaching hospitals. Compared to hospital A, hospital B had lower catheter utilization, more compliance with appropriate indications and maintenance, but higher urine culture use and more positive urine cultures per 1,000 patient days.

scholarly journals A comparative study of various screening tests of Asymptomatic Bacteriuria in pregnant women attending Antenatal Outpatient Department’

2021 ◽  
Vol 7 (4) ◽  
pp. 170-175
Author(s):  
Dr. Savitha B Hiremath ◽  
Keyword(s):  
Urinary Tract ◽  
Pregnant Women ◽  
Predictive Value ◽  
Bacterial Infections ◽  
Asymptomatic Bacteriuria ◽  
Outpatient Department ◽  
Screening Tests ◽  
Screening Methods ◽  
Tract Infections ◽  
Urine Microscopy

Introduction: Urinary tract infections are the most common bacterial infections in pregnancy.Asymptomatic bacteriuria (ASB) refers to the presence of bacteria in the urine of an individualwithout symptoms of urinary tract infection. ASB which occurs in 2-11% of pregnancies is a majorpredisposition to the development of pyelonephritis. Aims and objectives: The aims and objectivesof the study were to: Study the effectiveness of various screening tests: urine microscopy, gramstain, catalase test, leukocyte esterase test and nitrite test and to compare their sensitivity,specificity, positive predictive value and negative predictive value. Materials and Methods: Thestudy included 500 pregnant women attending the outpatient department over 18 months. The urinesamples collected in sterile containers were screened for urine microscopy, gram stain, catalase test,leukocyte esterase test and nitrite test. The samples were processed on CLED (Cysteine lactoseelectrolyte deficient) agar as the standard against which other screening tests are identified.Results: Gram’s stain (89.34%) was the most sensitive of all and the least reliable test was thecatalase test among the methods of screening tests. Conclusion: Urine culture is considered to bethe gold standard in detecting ASB in pregnant women. Gram’s stain of urine is a good screeningtest when compared to other screening methods. Screening for bacteria in all trimesters isnecessary to prevent the dangerous complications associated with ASB.

scholarly journals Evaluation of BacterioScan 216Dx in Comparison to Urinalysis as a Screening Tool for Diagnosis of Urinary Tract Infections in Children

2019 ◽  
Vol 57 (9) ◽  
Author(s):  
Ferdaus Hassan ◽  
Heather Bushnell ◽  
Connie Taggart ◽  
Caitlin Gibbs ◽  
Steve Hiraki ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Predictive Value ◽  
Screening Tool ◽  
Urine Culture ◽  
Antibiotic Use ◽  
Urine Samples ◽  
Maldi Tof ◽  
Tract Infections

ABSTRACTUrinalysis (UA) has routinely been used as a screening tool prior to urine culture set up. BacterioScan 216Dx is an FDA-cleared semiautomated system to detect bacterial growth in urine. The aim of this study was to evaluate 216Dx in comparison to UA for diagnosis of urinary tract infection (UTI) in children. Clean-catch, unpreserved urine samples from children aged <18 years were tested by 216Dx, and positive urine samples in media were processed for direct bacterial identification by matrix-assisted laser desorption ionization–time of flight (MALDI-TOF) mass spectrometry. Sensitivity and specificity of 216Dx and urinalysis (UA) were determined against urine culture. Of 287 urine samples obtained from children (median age, 108 months), 44.0% and 56.0% were UA positive and negative, respectively, while 216Dx detected 27% and 73% as positive and negative, respectively. Compared to culture, the overall sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 216Dx versus UA were 92.1% versus 97.3%, 82.7% versus 63.8%, 44.8% versus 29.1%, and 98.6% versus 99.3%, respectively. Among 216Dx true-positive (TP) samples (n= 35), 77.0% were successfully identified directly from broth by MALDI-TOF. Among urine samples that were identified as contaminated by culture (n= 127; 44%), the 216Dx detected 93 (73.0%) as negative while UA detected 69 (54.0%) as negative. Although the sensitivities of 216Dx and UA are comparable, the specificity of 216Dx was higher than that of UA. The 216Dx can be used as an alternative/adjunct screening tool to UA to rule out urinary tract infection (UTI) in children. Compared to culture, the faster turnaround time (3 hours) of 216Dx has the potential to reduce unnecessary antibiotic use and improve patient management.

Accuracy of Electronic Surveillance of Catheter-Associated Urinary Tract Infection at an Academic Medical Center

2014 ◽  
Vol 35 (06) ◽  
pp. 685-691 ◽  
Author(s):  
H. L. Wald ◽  
B. Bandle ◽  
A. Richard ◽  
S. Min
Keyword(s):  
Urinary Tract ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Medical Center ◽  
Academic Medical Center ◽  
University Hospital ◽  
Reference Standard ◽  
Electronic Surveillance ◽  
Tract Infections ◽  
Sensitivity Specificity

Objective.To develop and validate a methodology for electronic surveillance of catheter-associated urinary tract infections (CAUTIs).Design.Diagnostic accuracy study.Setting.A 425-bed university hospital.Subjects.A total of 1,695 unique inpatient encounters from November 2009 through November 2010 with a high clinical suspicion of CAUTI.Methods.An algorithm was developed to identify incident CAUTIs from electronic health records (EHRs) on the basis of the Centers for Disease Control and Prevention (CDC) surveillance definition. CAUTIs identified by electronic surveillance were compared with the reference standard of manual surveillance by infection preventionists. To determine diagnostic accuracy, we created 2 × 2 tables, one unadjusted and one adjusted for misclassification using chart review and case adjudication. Unadjusted and adjusted test statistics (percent agreement, sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV], and κ) were calculated.Results.Electronic surveillance identified 64 CAUTIs compared with manual surveillance, which identified 19 CAUTIs for 97% agreement, 79% sensitivity, 97% sensitivity, 23% PPV, 100% NPV, and κ of .33. Compared with the reference standard adjusted for misclassification, which identified 55 CAUTIs, electronic surveillance had 98% agreement, 80% sensitivity, 99% specificity, 69% PPV, 99% NPV, and κ of .71.Conclusion.The electronic surveillance methodology had a high NPV and a low PPV compared with the reference standard, indicating a role of the electronic algorithm in screening data sets to exclude cases. However, the PPV markedly improved compared with the reference standard adjusted for misclassification, suggesting a future role in surveillance with improvements in EHRs.Infect Control Hosp Epidemiol2014;35(6):685–691

scholarly journals Prevalence of Urinary Tract Infections in Children and Changes in Sensitivity to Antibiotics of E. coli Strains

2019 ◽  
Vol 70 (11) ◽  
pp. 3788-3792
Author(s):  
Adrian Hasegan ◽  
Maria Totan ◽  
Elisabeta Antonescu ◽  
Adrian Gheorghe Bumbu ◽  
Carmen Pantis ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Disk Diffusion ◽  
Diffusion Method ◽  
Sensitivity Testing ◽  
Disk Diffusion Method ◽  
E Coli ◽  
Positive Urine ◽  
Tract Infections

Urinary tract infections (UTIs) are the most common bacterial pathologies in children, but they are difficult to spot. The diagnosis relies on urine culture in order to measure the prevalence of the infection, to identify the etiology and the sensitivity of the germs to different antibiotics. Escherichia coli (E. coli) strains are the most common uro-pathogen germs. The change in sensitivity to antibiotic of these uro-pathogen bacteria should be closely monitored because the physicians should be informed about the evolution of the antibiotic resistance of E coli, for a more effective treatment in their fight against diseases. The study aimed to determine the prevalence of UTIs and the evolution of antimicrobial sensitivity for E. coli. This retrospective study was performed over a period of 4 years, 2013-2016, and included all the patients admitted in the Children�s Hospital, aged 0-18 years, with the suspicion of UTIs; also, the standard culture techniques for urine samples, the modified Kirby-Bauer disk diffusion method for the antibiotic sensitivity testing, and the disk diffusion method to confirm the ESBL production by the clinical isolates of E. coli in urine were used. The statistical analysis was performed using the proportions of sensitive, resistant and intermediates. Descriptive statistics like the total, mean and percentage were performed using the Statistical Package for the Social Sciences (SPSS), version 15.0 and Microsoft Excel. From 15389 urine cultures processed in 4 years, 1530 were positive (9.9 %). Among these positive urine cultures, 1056 (69 %) were positive for E. coli. Testing the E. coli to a range of antibiotics, according to CLSI standard, a high resistance to Ampicillin (69-96%), Amoxicillin/Clavulanic acid (32-70%), Trimethoprim/Sulfamethoxazole (36-42%) was observed and low levels of resistance to Ceftazidime, Cefuroxime, Cefpodoxime, Gentamycin, Nalidixic acid. Among E. Coli strains, 9-9.6 % were ESBL positive. Despite the low number of positive urine cultures in a paediatric population, it is very important to perform the urine culture in order to correctly identify the etiology of UTIs, recommend the right antibiotic, and avoid the wrong use of the antibiotics in children.

scholarly journals Are Urinalyses Used Inappropriately in the Diagnosis of Urinary Tract Infections?

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S350-S350 ◽  
Author(s):  
Ghada Elshimy ◽  
Vincent Mariano ◽  
Christina Mariyam Joy ◽  
Parminder Kaur ◽  
Monisha Singhal
Keyword(s):  
Urinary Tract ◽  
Antibiotic Treatment ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
White Blood Cells ◽  
Asymptomatic Bacteriuria ◽  
Further Education ◽  
Positive Urine ◽  
Tract Infections ◽  
Hospital Wards

Abstract Background One of the most readily available and cost effective tests in the diagnosis of urinary tract infections (UTI) is the urinalysis. Problems arise when antibiotic treatment is initiated in a patient who does not display typical signs and symptoms of UTI and for whom a urinalysis was obtained for other reasons. Methods This was a retrospective observational study carried out on 1000 patients with positive urine nitrite. Medical records were identified with subsequent analysis of urine culture and symptomatology. Recorded and analyzed data included: age, sex, location (emergency room (ER) or hospital ward), findings on urinalysis (pH, presence of leukocyte esterase(LE), epithelial cells, bacteria, and white blood cells (WBCs)) and antibiotic treatment. Results Of these 1000 patients with positive nitrite, we excluded 815 patients (81 had missing data, 466 met exclusion criteria and 268 had symptomatic UTI). 185 were found to not have any symptoms of a UTI. Inappropriate antibiotic treatment occurred in 108/185 patients (58.4%) and was significantly associated with greater amounts of bacteria and WBCs in the urinalyses (P = 0.008 and P = 0.029, respectively). It was also significantly more likely to occur in the ER than the hospital wards (92/147 treated in the ER vs. 16/37 treated on the hospital wards, P = 0.033). There was no significant association between antibiotic treatment and age, sex, urine pH, urine LE, and urine epithelial cell amounts (P &gt; 0.05). Urine cultures were not obtained in 69.7% of patients. A positive urine culture was significantly associated with inappropriate antibiotic treatment (P = 0.0006). The two most common presenting complaints were psychiatric complaints (21.6%) and vaginal bleeding (14.6%). Conclusion Urinalysis can be an invaluable diagnostic tool, but must be used and interpreted appropriately. There is a misperception that pyuria with bacteriuria defines UTI. However, positive results on a urinalysis alone in an asymptomatic patient is not enough to diagnose a UTI, and antibiotic treatment is only indicated in specific circumstances as outlined by IDSA guidelines for the treatment of asymptomatic bacteriuria. Further education targeting appropriate interpretation of urinalyses and IDSA guidelines is needed to decrease the unnecessary use of antibiotics. Disclosures All authors: No reported disclosures.

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