open access

Vol 49, No 3 (2017)
Original and clinical articles
Published online: 2017-07-12
Submitted: 2016-11-28
Accepted: 2017-05-01
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Sensitivity and specificity of urinalysis samples in critically ill patients

Sean P. Lee, Terrie Vasilopoulos, Thomas James Gallagher
DOI: 10.5603/AIT.a2017.0036
·
Anaesthesiol Intensive Ther 2017;49(3):204-209.

open access

Vol 49, No 3 (2017)
Original and clinical articles
Published online: 2017-07-12
Submitted: 2016-11-28
Accepted: 2017-05-01

Abstract

BACKGROUND: Pre-emptive screening of urine for patients admitted to an intensive care unit can result in the misinterpretation of data and over- or under-treatment of urinary tract infection.

METHODS: Data were studied from 169 consecutive patients admitted to the neurologic or burn intensive care unit at Shands Hospital at the University of Florida. All patients had a urinary catheter in place at the time of admission. Urinalysis and urine culture were sent for analysis. Data included leukocyte esterase, urine nitrate, urine protein, pyuria or urine white blood cell count, and culture.

RESULTS: Leukocyte esterase and pyuria were the most sensitive indicators of a positive urine culture at 87.5% (95% CI: 71.3–100%) and 73.3% (95% CI: 51.0–95.7%), respectively; urine nitrate was specific at 100%. More than half of the patients (56.3%) with positive cultures did not initially receive antibiotics.

CONCLUSION: The combination of leukocyte esterase and urine nitrate provides the best indicator for the initiation of antibiotic coverage for urinary tract infection prior to culture availability.

Abstract

BACKGROUND: Pre-emptive screening of urine for patients admitted to an intensive care unit can result in the misinterpretation of data and over- or under-treatment of urinary tract infection.

METHODS: Data were studied from 169 consecutive patients admitted to the neurologic or burn intensive care unit at Shands Hospital at the University of Florida. All patients had a urinary catheter in place at the time of admission. Urinalysis and urine culture were sent for analysis. Data included leukocyte esterase, urine nitrate, urine protein, pyuria or urine white blood cell count, and culture.

RESULTS: Leukocyte esterase and pyuria were the most sensitive indicators of a positive urine culture at 87.5% (95% CI: 71.3–100%) and 73.3% (95% CI: 51.0–95.7%), respectively; urine nitrate was specific at 100%. More than half of the patients (56.3%) with positive cultures did not initially receive antibiotics.

CONCLUSION: The combination of leukocyte esterase and urine nitrate provides the best indicator for the initiation of antibiotic coverage for urinary tract infection prior to culture availability.

Get Citation

Keywords

urinary tract infection; leukocyte esterase; urine nitrate; urine white blood cell count; urine protein

About this article
Title

Sensitivity and specificity of urinalysis samples in critically ill patients

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 49, No 3 (2017)

Pages

204-209

Published online

2017-07-12

DOI

10.5603/AIT.a2017.0036

Bibliographic record

Anaesthesiol Intensive Ther 2017;49(3):204-209.

Keywords

urinary tract infection
leukocyte esterase
urine nitrate
urine white blood cell count
urine protein

Authors

Sean P. Lee
Terrie Vasilopoulos
Thomas James Gallagher

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