Validity of the urine dipslide under daily practice conditions. 2003

Ron Winkens, and Hanny Nelissen-Arets, and Ellen Stobberingh
Transmural Care Unit Department of Medical Microbiology, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands. ron.winkens@hag.unimaas.nl

BACKGROUND So far, the validity of urine dipslides has been studied only under optimal conditions, which may not reflect the situation in daily practice. OBJECTIVE We studied the validity of the urine dipslide as performed under daily practice conditions and assessed the influence of the incubation period (24 h versus 48 h) on validity. METHODS Fresh urine samples of patients with signs/symptoms of a possible urinary tract infection (UTI) were examined in general practice via a nitrite test, a urine sediment and a dipslide. A second dipslide was inoculated and sent to the hospital microbiology laboratory for culture. This culture acted as gold standard. We calculated the sensitivity and specificity of the tests performed. RESULTS Of the 273 patient episodes included, 62% had a UTI (166 of 268 cultures). The sensitivity of the dipslide performed in daily general practice was 73% and the specificity was 94%. CONCLUSIONS The validity of the dipslide read under practice conditions is lower than under optimal conditions. Actions to improve performance are needed. Nonetheless, using the dipslide instead of the sediment as a second step after the nitrite test would improve the diagnostic work-up of UTI.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009426 Netherlands Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, and Sint Maarten, formerly included in the NETHERLANDS ANTILLES. Holland,Kingdom of the Netherlands
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005194 Family Practice A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family. Family Practices,Practice, Family,Practices, Family
D005260 Female Females
D006302 Health Services Research The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed) Health Care Research,Medical Care Research,Research, Health Services,Action Research,Health Services Evaluation,Healthcare Research,Research, Medical Care,Evaluation, Health Services,Evaluations, Health Services,Health Services Evaluations,Research, Action,Research, Health Care,Research, Healthcare
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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