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PubMed2002

The impact of empirical management of acute cystitis on unnecessary antibiotic use.

BACKGROUND: Guidelines for the management of acute cystitis support empirical antibiotic treatment; however, up to half of symptomatic women have negative urine cultures. OBJECTIVE: To determine whether empirical treatment leads to unnecessary antibiotic prescriptions in women with symptoms of acute cystitis. METHODS: A cohort of 231 women (defined as females aged 16 years and older) presenting to family physicians' offices with symptoms of cystitis underwent a standardized clinical assessment, urine dip testing, and culture. Recommendations for urine testing and antibiotic treatment under 3 empirical strategies were compared with observed physician management and a logistic regression model for the outcomes of antibiotic prescriptions, urine culture testing, and unnecessary antibiotics, defined as a prescription where the subsequent urine culture was negative. RESULTS: There were 123 positive urine cultures (53.3%). Physicians prescribed antibiotics to 186 women (80.9%), of whom 74 (39.8%) were culture negative. Unnecessary antibiotic use was similar for 2 guidelines recommending empirical antibiotic treatment without testing for pyuria (41.4% and 40.6%). Treating women with classic cystitis symptoms and pyuria would have decreased unnecessary antibiotic use (26.2%; P =.02) but resulted in fewer women with confirmed urinary tract infection receiving immediate antibiotics (66.4% vs 91.8% usual care; P<.001). A derived prediction model incorporating testing for pyuria and nitrites would also have reduced unnecessary antibiotic use (27.5%; P =.03), but more women with confirmed urinary tract infection would have received immediate antibiotics (81.3%; P =.01). CONCLUSIONS: Empirical antibiotic treatment of acute cystitis in women without testing for pyuria promotes unnecessary antibiotic use. A simple decision rule provides for prompt treatment of infected women while reducing antibiotic overuse and unnecessary urine testing.

Acute Disease↗

PubMedDate not supplied

Urinalysis in urinary tract infection.

In 376 children, between 6 months and 5 years of age, with suspected urinary tract infection, 4 parameters of a routine urine examination were correlated with culture reports. In diagnosing urinary infection, the sensitivity and specificity of proteinuria was 79 and 80% respectively, that of bacteriuria 78 and 96% and that of pyuria > 10 wbc/hpf 80 and 82% respectively. 61% among the culture positive groups had all these three parameter present, as against only 0.5% in the culture negative group (P < 0.001). All these 3 parameters were absent in 70% in the culture negative group, as against 8% in the culture positive group (P < 0.001). Bacteriuria in association with either proteinuria or Pyuria > 10 Wbc/hpf had 98% specialty is diagnosis. In diagnosis UTI, Pyuria > 10 wbc/hpf was significantly more specific (82:66.6) than the conventional > 5 wbc/hpf. Isolated proteinuria, isolated pyuria, isolated bacteriuria and microscopic haematuria were not features of urinary tract infection in children. Urine culture can be more selectively done if the routine urinalysis is well interpreted. In the absence of dependable culture facilities, a routine urine examination can be reliably used in the diagnosis of UTI in children.

Child, Preschool↗

PubMed2002

False-positive results of the NMP22 test due to hematuria.

PURPOSE: The problem with available markers for bladder cancer is their low specificity and low positive predictive value due to false-positive results. False-positive results of the NMP22 nuclear matrix protein test (Matritech, Cambridge, Massachusetts) are usually observed in some clinical categories that are usually associated with hematuria and pyuria. This problem is especially serious in bladder cancer since 85% of patients present with hematuria. We investigated the effect of the degree of hematuria and pyuria on NMP22 results in an experimental model and human subjects. MATERIALS AND METHODS: This study was performed in 202 urine samples from 30 healthy individuals (group 1), 20 with symptomatic urinary tract infection (group 2) and 32 with known bladder carcinoma (group 3). In the first group to achieve 0, 10, 100, 1,000 and 5,000 red blood cells per high power field the blood obtained from each patient was added to test tubes at 0.02, 0.2, 2 and 10 microl, respectively. RESULTS: In the first group median urinary NMP22 in healthy individuals was 4 units per ml. (range 1.6 to 9.5). When blood was added to the urine sample, the NMP22 increase paralleled the increase in the amount of red blood cells in the sediment. When greater than 2 microl./ml. blood or 1,039.5 red blood cells per high power field (range 278 to 1,438) were added to the urine of a healthy individual, the NMP22 level reached and surpassed the level in patients with bladder carcinoma. The leukocyte count in the urine sediment also had a significant impact on urinary NMP22 in group 2. The degree of hematuria and pyuria did not significantly effect NMP22 in group 3. The sensitivity, specificity, positive and negative predictive values of NMP22 were 78.1%, 66%, 59.5% and 82.5%, respectively. Test sensitivity increased as grade and stage progressed. CONCLUSIONS: In an experimental model pyuria and hematuria significantly affected urinary NMP22. The effect of white blood cells was more pronounced than that of red blood cells. The source of NMP22 in isolated hematuria remains to be elucidated. On the other hand, in group 3 the tumor was the main source of NMP22, and urinary erythrocytes and/or leukocytes had a negligible effect.

Biomarkers, Tumor↗

PubMed2000

[Clinical evaluation of urinary basic fetoprotein and the BTA test for detection of bladder cancer].

We compared the results of urinary basic fetoprotein (BFP) and the BTA test with those of urinary cytology in patients with bladder cancer. We also analyzed the urinary BFP and the BTA test results in patients with benign diseases and postoperative bladder cancer with no evidence of recurrence. The cutoff value for urinary BFP was set at 10 ng/ml. Classes 4 and 5 according to urinary cytology were defined as positive. The sensitivity of urinary BFP for Ta, 1 bladder cancer was significantly higher than that of urinary cytology (p < 0.05). The urinary cytology positive rate for Ta, 1 bladder cancer improved when combined with urinary BFP and the BTA test. The urinary BFP positive rate for benign diseases was significantly higher in patients with pyuria than in patients without pyuria (p < 0.05). The BTA test positive rate for benign diseases was higher in patients with pyuria than in patients without pyuria. The urinary BFP and the BTA test positive rates for postoperative bladder cancer with no evidence of recurrence was significantly higher in patients with urinary diversion than in patients without urinary diversion (BFP: p < 0.01, BTA: p < 0.05).

Adult↗

PubMed1991

[Study of the long-term administration of ofloxacin to the patients following transurethral resection of the prostate].

The present study was undertaken to evaluate the clinical efficacy of long-term administration of ofloxacin (OFLX) to the patients following transurethral resection of the prostate. The patients were randomly divided into two groups: A and B. All the patients were administered flomoxef (FMOX) intravenously for 3 days following transurethral resection of the prostate (TUR-P). In group A, 100 mg of OFLX twice daily was thereafter administered for 4 to 15 weeks to 22 patients until they showed an improvement in pyuria. In group B, which served as a control, neither OFLX nor any other antibiotics were administered to 26 patients until they showed an improvement in pyuria. No patients complained of urination trouble due to infection. At the same time, cultures of bacillus in the urine were also examined 4 days, 7 days and 2 weeks after TUR-P with these two groups. The mean days necessary for the improvement of pyuria were 64.9 +/- 20.5 in group A, 66.3 +/- 18.4 in group B. At 2 weeks after TUR-P, bacillus in the urine were negative in 19/22 patients in group A, and 14/26 in group B. Chi-square test showed significance for these two groups. Accordingly, OFLX was useful for bacillus in the urine, but OFLX was not so useful for shortening the continuance of pyuria of post TUR-P. No patients complained of nausea or any other complications during the study.

Aged↗

PubMed1991

[A study on the treatment duration of an antibacterial agent in complicated urinary tract infections. Utility and recurrence after 14-day treatment by fleroxacin].

In this study, fleroxacin (FLRX), a new quinolone derivative, was orally given at 300 mg once daily for 14 days to 102 patients with non-catheterized complicated urinary tract infections in order to determine the optimal treatment duration. We investigated its efficacy at day 5-7 and day 14, according to the criteria proposed by the Japanese UTI Committee, and also to the recurrence rate after the withdrawal. The results were as follows: 1. Overall clinical efficacy rates were 86% at day 5-7 and 84% at day 14. Both incidence of bacterial replacement in bacteriuria and normalization in pyuria were increased at day 14 as compared with those at day 5-7. 2. Bacteriological eradication rates were 91% at day 5-7 and 89% at day 14. 3. Clinical efficacy rates from physicians' evaluation were 86% at day 5-7 and 88% at day 14. 4. Incidence of side effects was 9.1%, and most of the cases were gastrointestinal symptoms which appeared within 4 days. Slight and transitory changes in laboratory findings were noted in 2.3% of evaluable cases. 5. With the occurrence of pyuria and bacteriuria as markers, the "no recurrence" rates were 63% at 1 week, 54% at 2 weeks, 61% at 3 weeks, 81% at 4-6 weeks after the withdrawal, and the "recurrence" rates were 4%, 4%, 6% and 5%, respectively. Remaining cases were judged as "reserved assessment". Generally, aggravation of bacteriuria was found but the aggravation of pyuria was observed in only few cases. 6. According to breakdown of cases with bacteriuria only, cure rate was 67% and recurrence rate was 33%. Re-infections were observed much more frequently than relapse based on the identification of infecting organisms. These results suggest that sufficient bacteriological eradication and clinical efficacy could be obtained by 14-day treatment of FLRX in non-catheterized complicated urinary tract infections. The efficacy of the treatment became evident around day 7. In approximately 30% of the cases in which eradication of the initial causative organisms was observed at day 14 reappearance of bacteriuria (greater than or equal to 10(3) CFU/ml) occurred after withdrawal of the antibiotic, but cases with pyuria were few, and the incidence of true recurrence was generally low. Onset of side effect after 5-day was not seen, hence FLRX seemed to be a safe agent.

Administration, Oral↗

PubMed1994

Detection of Chlamydia trachomatis in general practice urine samples.

BACKGROUND: Chlamydia trachomatis is frequently overlooked as a cause of dysuria and urinary frequency in general practice patients. AIM: This study set out to determine the impact of performing chlamydial antigen detection on sterile pyuria samples from patients aged 16-65 years and which were submitted to a hospital microbiology laboratory by general practitioners in the Winchester health district for routine microbiological investigations. METHOD: Chlamydial antigen detection was performed by enzyme immunoassay and direct immunofluorescence. The cost of performing the test was estimated. In the first year of the study (1991) questionnaires were sent to general practitioners whose patients had a positive test result. RESULTS: A total of 1025 samples of sterile pyuria were received at the laboratory between January 1991 and March 1993. Chlamydial antigen was detected in 54 samples (5%); 22 men and 32 women aged between 16 and 57 years (mean 25 years). The detection rate was highest in the 16-20 years age group (22% of men had a positive sample and 7% of women). Completed questionnaires from 27 general practitioners revealed that 59% of their patients were referred to the genitourinary clinic for treatment and contact tracing. The others were treated by the general practitioner. The cost of the screening programme per cure in this population was estimated to be 246 pounds. CONCLUSION: C trachomatis is a significant pathogen which may go unrecognized and untreated. The cost, medically and financially, of screening for this pathogen and treating infected patients and contacts is likely to be less than ignoring it, particularly if screening is confined to the 16-30 years age group. General practitioners should consider the diagnosis of chlamydial infection in young adult patients with sterile pyuria, and microbiology laboratories should screen sterile pyuria samples for chlamydial antigen.

Adolescent↗

PubMed1993

[Clinical studies on the need of prophylactic antibiotics during extracorporeal shock wave lithotripsy].

We examined whether prophylactic antibiotics are necessary or not during the ESWL treatment for patients with urolithiasis. Twenty-eight patients with unilateral renal or ureteral stones composed of calcium oxalate, calcium phosphate or the mixed stones were treated with MPL 9000 between May 12 and September 30, 1992. Although 17 patients (60.7%) had complications of pyuria before treatment, none of the 28 patients had taken any prophylactic antibiotics during the treatment. To evaluate the clinical signs of infection, we examined the white blood cell count, in blood and urine sediment and serum C-reactive protein (CRP) value at the time of 1, 3 and 7 days after ESWL treatment, and body temperature and urine culture at the time immediately after the treatment in addition to the above-mentioned days, compared with the pre-treatment data. White blood cell count at one day after ESWL treatment was significantly elevated both in the patients with and without pyuria, while body temperature at the time immediately after the treatment was significantly elevated only in the patients with pyuria. Six of the 23 patients (26.1%) with preoperative sterile urine and who had urine culture immediately after ESWL, had bacteriuria. However, none of the 28 patients had any clinically significant infectious complications during ESWL treatment without any antibiotics therapy. We concluded that it is important to examine urine culture immediately after ESWL treatment for early protection from complication of urinary tract infection and that administration of prophylactic antibiotics is not necessary during ESWL treatment for patients with non-infection stones even concomitantly with pyuria.

Adult↗

PubMed1988

Postoperative prophylaxis with norfloxacin in patients requiring bladder catheters.

The effect of once daily doses of 200 mg oral norfloxacin on the occurrence of catheter-associated bacteriuria (greater than 1000 CFU/ml) and pyuria was studied in 105 post-operative gynaecologic patients. Norfloxacin was given from the second day after surgery until catheter removal. Bacteriuria developed in 32 of 51 (63%) control patients compared to 8 of 54 (15%) patients receiving norfloxacin (p less than 0.001). Pyuria was present in 22 of 51 (43%) control subjects versus only 3 of 54 (5%) patients treated with norfloxacin (p less than 0.001). Bacteria isolated from control patients comprised species of Enterobacteriaceae (40%), Staphylococcus (35%), and Streptococcus (17%); seven isolates were resistant to multiple antibiotics reflecting their nosocomial origin. In contrast, strains isolated from norfloxacin-treated patients comprised non-fermenting gram-negative rods (79%, usually Alcaligenes or Acinetobacter spp.) and faecal streptococci (12%). It is concluded that once daily doses of 200 mg oral norfloxacin are effective in reducing the rate of catheter-associated bacteriuria and pyuria following reconstructive gynaecologic surgery.

Adult↗

PubMed1995

Bacteriuria in children with neurogenic bladder treated with intermittent catheterization: natural history.

OBJECTIVE: To determine whether bacteriuria unassociated with symptoms in patients with neurogenic bladder will lead to symptomatic infection and/or deterioration of the upper urinary tract if left untreated, we examined whether bacteriuria persisted in bladder urine of children with neurogenic bladder treated with clean intermittent catheterization (CIC) and whether persistence of bacteria led to symptomatic infection or deterioration of the upper urinary tract. DESIGN: Weekly home visits were made during 6 months of surveillance of 14 children on the CIC regimen with a normal upper urinary tract and no reflux (as determined by renal ultrasonography, voiding cystourethrography, and serum creatinine measurement). During visits a sample of bladder urine was obtained by CIC, and signs and symptoms of urinary tract infection and all medications were recorded. RESULTS: Fourteen children were observed for 323 weeks. Cultures of 70% (172/244) of the urine samples collected were positive for organisms (> or = 10(4) colony-forming units per milliliter), 152 (88%) for the usual pathogens and 20 (12%) for commensal organisms. Bacteriuria was associated with pyuria two thirds of the time, regardless of bacterial species. Carriage of the same pathogen for 4 weeks or longer, with associated pyuria, was common during surveillance. Despite frequent episodes of bacteriuria with associated pyuria, there were only five symptomatic infections during the 323 patient-weeks. Children remained clinically well during the study period, and their upper urinary tract did not deteriorate. CONCLUSION: Bacteriuria persists for weeks in symptom-free children being treated with CIC for neurogenic bladder associated with a normal upper urinary tract. Before attempts are made to eradicate bacteriuria, treatment should be proved to be beneficial to this population.

Adolescent↗

PubMed1985

Urinary tract infections in male spinal cord injured patients. Part two: Diagnostic value of symptoms and of quantitative urinalysis.

Seventy paired samples of urine, obtained by collection of a clean voided specimen and by suprapubic aspiration (SPA) of the bladder, were obtained from 43 male SCI patients who were free of indwelling catheters. The relationship of the presence or absence of symptoms and the degree of pyuria (determined quantitatively using a haemocytometer) to the presence or absence of bacteriuria (SPA specimen) was determined. Symptoms were poorly predictive of bacteriuria with concordance seen only 40% of the time. Most bacteriuric episodes (37/51-72.5%) were asymptomatic. The quantity of WBC in voided urine accurately reflected that in SPA urine (r = 0.825), indicating that urodynamics in SCI patients who received sphincterotomies are different than in normal persons. Pyuria (greater than or equal to 10(4) WBC per cc urine) was an excellent predictor of UTI--37 of 38 (97.4%) had UTI. However, 40.6% of samples with WBC less than 10(4) were also culture positive. Overall, consideration of the presence or absence of pyuria in relation to the presence of bacteriuria provided a sensitivity of 74.0%, specificity of 95.9%, and predictive value of a positive test of 97.4%. The predictive value of a negative test (WBC less than 10(4), however, was only 59.4%. There was poor correlation between absolute bacterial and WBC count. The point of cutoff for bacterial count correlating with 10(4) WBC count was not statistically significant in these patients; this is possibly due to repeated bacterial contamination from anterior urethra. While symptom status was often misleading, the presence of greater than 10(4) WBC per cc of urine was highly predictive of the presence of bacteriuria in male SCI patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

PubMed1993

Progression from asymptomatic to symptomatic urinary tract infection in patients with SCI: a preliminary study.

The purpose of this prospective pilot study was to (1) evaluate the role of pyuria in predicting the progression from asymptomatic to symptomatic urinary tract infection (UTI) in spinal cord-injured patients who undergo sterile intermittent bladder catheterization and (2) evaluate the impact of treating asymptomatic UTI on this progression. Twenty hospitalized patients were randomized to either the treatment group (10 subjects) or the control group (10 subjects). Weekly urine samples were obtained for quantitation of bacterial growth and pyuria. Neither the level nor the trend of pyuria helped predict the imminent progression to symptomatic UTI. Thirty percent of patients in the treatment group developed symptomatic UTI vs 70 percent of patients in the control group; it took a significantly longer time for patients in the treatment vs control group to develop symptomatic UTI (median number of days: 72 vs 7, respectively; p < 0.003). Further analysis of the long-term impact of antibiotic treatment of asymptomatic UTI is warranted.

Adult↗

PubMed2001

Urinary findings in asymptomatic subjects with spina bifida treated with intermittent catheterization.

The urines from 43 asymptomatic children with spina bifida were examined. Eighty-one percent were abnormal because of bacteriuria and pyuria (51%), bacteriuria alone (26%) or pyuria alone (5%). Interleukin-8 was elevated in 54% of the abnormal urines. The presence of pyuria and interleukin 8 suggests that the asymptomatic bacteriuria reflects low grade infection rather than colonization.

Adolescent↗

PubMed1995

Epidemiologic and diagnostic aspects of bacteriuria: a longitudinal study in older women.

OBJECTIVE: To examine month-by-month variability of bacteriuria in a cohort of older women and to evaluate the performance of rapid diagnostic tests commonly used to indicate the presence of significant bacteriuria. DESIGN: Prospective, observational study. SETTING: Community housing sites and a long-term care institution. PARTICIPANTS: Sixty-one women, mean age 77.6, took part in the study. MEASUREMENTS: Midstream clean-catch urine samples and medical information on subjects were collected at baseline, and then monthly for 6 months. RESULTS: Bacteriuria alone (> or = 10(5) organisms per mL) occurred in 17% of all urine samples (28% of patients), bacteriuria with pyuria in 15% (26% of patients), and bacteriuria with symptoms in 3% (10% of patients). Spontaneous clearance of bacteriuria with pyuria was common (P = .30), as were new occurrences (P = .12) over 6 months of follow-up. For the outcome of bacteriuria with symptoms, sensitivity of urinary diagnostic tests such as bacteria and pyuria on microscopic analysis, and leukocyte esterase on dipstick testing, ranged from 79 to 93%. Negative predictive values of these tests approached 100%. CONCLUSIONS: Bacteriuria was a very common event, occurring in almost one-fifth of all urine samples and one-third of all subjects during 6 months of follow-up. Month-by-month follow-up indicates that the natural history of bacteriuria is marked by frequent spontaneous alternation between positive and negative events. The high negative predictive value of many simple diagnostic tests commonly used for urinary tract disease suggests that they can quickly and cost-effectively rule out bacteriuria in the older female patient.

Aged↗

PubMed1996

Urinary symptoms, sexual intercourse and significant bacteriuria in male patients attending STD clinics.

OBJECTIVE: To assess the relationship between sexual behaviour, urinary symptoms, urinalysis and bacteriuria in men attending STD clinics. DESIGN: A prospective study recording sexual behaviour, urinary symptoms and collecting mid-stream urine specimens. SETTING: Two West Midlands STD clinics, UK. SUBJECTS: 1086 new male patients. RESULTS: 704 patients had had sexual intercourse (SI) within 14 days of testing, 424 had urinary symptoms and 122 had pyuria. All 13 patients with positive culture had SI < 14 days before testing, urinary symptoms and pyuria. No association was found between sexual orientation, type of SI, number of sexual partners, condom usage and bacteriuria. CONCLUSION: Bacteriuria does not behave as an STD but SI may be a factor in acquiring bacteriuria. Dysuria with or without urethral discharge is the most predictive symptom of bacteriuria. Pyuria has a high sensitivity for predicting bacteriuria among males.

Adolescent↗

PubMed2000

Asymptomatic gonorrhoea and chlamydial infection in a population-based and work-site based sample of men in Kilimanjaro, Tanzania.

The aim of this study was to screen healthy rural and urban Tanzanian men for chlamydial infection and gonorrhoea, and determine the prevalence and the predictive value of urethral symptoms, signs and pyuria. In 2 cross-sectional surveys, 796 men were interviewed regarding symptoms and examined for signs of urethritis. Gonorrhoea was detected by culture/gram-stained smears, Chlamydia trachomatis by antigen immunoassay, and pyuria by leukocyte esterase dipstick test. The prevalence of chlamydial infection, gonorrhoea and pyuria among rural men was 9.6%, 0.4%, and 12.7%, and among urban bar workers 7.4%, 8.1% and 6.3% respectively. Among all, 0.6% had urethral discharge confirmed by examination, while 2.6% reported urethral discharge and 7.4% dysuria. Among chlamydia-infected men, 59 (89%) of the 66 cases did not have urethritis symptoms or signs. Similarly, 24 (88%) of 28 men with gonorrhoea were asymptomatic. Treatment based on the urethral discharge sign, would have detected only one out of 92 cases with gonorrhoea and/or chlamydia in these populations.

Adolescent↗

PubMedDate not supplied

Rapid urinalysis assays for the diagnosis of urinary tract infection.

Urinary tract infection (UTI) in premenopausal women is a frequent complaint in general practice. UTI is usually diagnosed on the basis of clinical symptoms and the use of one or more laboratory tests, the most common being rapid urinalysis reagent assays (urine dip) or midstream urine culture. In order to correlate the leucocyte esterase results of a rapid urinalysis assay with direct urine microscopy for pyuria, undiluted non-centrifuged urine samples from 206 volunteer female healthcare professionals were subjected to analysis using direct urine microscopy using a counting chamber and a rapid urinalysis assay. Of the 206 specimens, 74 were positive for leucocyte esterase using the rapid urinalysis assay, and 39 specimens demonstrated significant pyuria (greater than or equal to 10 leucocytes/microl) on direct microscopy. When the leucocyte esterase results were correlated with the direct urine microscopy results, an assay reading of 15 leucocytes/microl ('trace' on the visual scale) had a sensitivity of 91%, specificity of 79%, positive predictive value of 53% and a negative predictive value of 97%. An assay reading of 25 leucocytes/microl ('+' on the visual scale) or greater had a sensitivity of 63%, specificity of 95%, positive predictive value of 75% and a negative predictive value of 91%. In premenopausal, non-pregnant females, a rapid urinalysis assay result of 25 leucocytes/microl or greater will predict significant pyuria on urine microscopy with reasonable confidence, thereby reducing the need for more costly urine cultures.

Adult↗

PubMed1993

Diagnosis of urinary tract infection by urine microscopy using a disposable counting chamber.

Routine urinalysis is performed as a screening test for urinary tract infection (UTI), but is not very reliable. We assessed the usefulness of microscopic examination of unspun urine using a disposable slide with counting chambers for the diagnosis of UTI caused by a variety of species of bacilli. One hundred and seventy-two urine samples were obtained from 113 subjects (60 male and 53 female), including 84 inpatients, aged 20-96 years. The urine samples were examined for bacteriuria and pyuria using a counting chamber, and the reliability of this method in predicting significant bacteriuria defined by routine urine culture and Gram stain of urine smears was analyzed. Significant bacteriuria was diagnosed in 68 urine samples, including 34 from indwelling catheters, from 52 patients mostly having underlying diseases. Only 12 of the positive urine samples contained E. coli, with a variety of other bacilli including cocci found in the rest. The counting chamber method detected bacteriuria in 64 of these 68 positive samples (sensitivity = 94%). Specificity was 88%. While the sensitivity and specificity of pyuria (WBC > 10 microliters-1) were 79 and 71%, respectively, both sensitivity and negative predictive value were as high as 97% when bacteriuria or pyuria was present. We demonstrated that urine microscopy on a disposable counting chamber is a simple, sensitive and time- and cost-saving method for the diagnosis of UTI caused by a variety of bacterial species including cocci.

Adult↗