Urine Flow Cytometry and Dipstick Analysis in Diagnosing Bacteriuria and Urinary Tract Infections among Adults in the Emergency Department—A Diagnostic Accuracy Trial
Urinary tract infections (UTIs) are a leading infectious cause of emergency department admission. Early UTI diagnosis is challenging, and a faster, preferably point-of-care urine analysis is necessary. We aimed to evaluate the diagnostic accuracy of urine flow cytometry (UFC) and urine dipstick anal...
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MDPI AG
2024-02-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/14/4/412 |
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| author | Mathias Amdi Hertz Isik Somuncu Johansen Flemming S. Rosenvinge Claus Lohman Brasen Eline Sandvig Andersen Claus Østergaard Thor Aage Skovsted Eva Rabing Brix Petersen Stig Lønberg Nielsen Christian Backer Mogensen Helene Skjøt-Arkil |
| author_facet | Mathias Amdi Hertz Isik Somuncu Johansen Flemming S. Rosenvinge Claus Lohman Brasen Eline Sandvig Andersen Claus Østergaard Thor Aage Skovsted Eva Rabing Brix Petersen Stig Lønberg Nielsen Christian Backer Mogensen Helene Skjøt-Arkil |
| author_sort | Mathias Amdi Hertz |
| collection | DOAJ |
| description | Urinary tract infections (UTIs) are a leading infectious cause of emergency department admission. Early UTI diagnosis is challenging, and a faster, preferably point-of-care urine analysis is necessary. We aimed to evaluate the diagnostic accuracy of urine flow cytometry (UFC) and urine dipstick analysis (UDA) in identifying bacteriuria and UTIs. This study included adults suspected of an infection admitted to three Danish emergency departments. UFC and UDA were the index tests, and urine culture and an expert panel diagnosis were the reference tests. We used logistic regression and receiver operator characteristics curves to find each test’s optimal model and cut-off. We enrolled 966 patients and performed urine cultures on 786. Urine culture was positive in 337, and 200 patients were diagnosed with a UTI. The UFC model ruled out bacteriuria in 10.9% with a negative predictive value (NPV) of 94.6% and ruled out UTI in 38.6% with an NPV of 97.0%. UDA ruled out bacteriuria in 52.1% with an NPV of 79.2% and UTI in 52.8% with an NPV of 93.9%. Neither UFC nor UDA performed well in ruling out bacteriuria in our population. In contrast, both tests ruled out UTI safely and in clinically relevant numbers. |
| first_indexed | 2024-03-07T22:35:58Z |
| format | Article |
| id | doaj.art-d1157e82581f4041870af456b7214676 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-07T22:35:58Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-d1157e82581f4041870af456b72146762024-02-23T15:13:49ZengMDPI AGDiagnostics2075-44182024-02-0114441210.3390/diagnostics14040412Urine Flow Cytometry and Dipstick Analysis in Diagnosing Bacteriuria and Urinary Tract Infections among Adults in the Emergency Department—A Diagnostic Accuracy TrialMathias Amdi Hertz0Isik Somuncu Johansen1Flemming S. Rosenvinge2Claus Lohman Brasen3Eline Sandvig Andersen4Claus Østergaard5Thor Aage Skovsted6Eva Rabing Brix Petersen7Stig Lønberg Nielsen8Christian Backer Mogensen9Helene Skjøt-Arkil10Department of Infectious Diseases, Odense University Hospital, 5000 Odense, DenmarkDepartment of Infectious Diseases, Odense University Hospital, 5000 Odense, DenmarkDepartment of Clinical Microbiology, Odense University Hospital, 5000 Odense, DenmarkDepartment of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, DenmarkDepartment of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, DenmarkDepartment of Clinical Microbiology, Lillebælt Hospital—University Hospital of Southern Denmark, 7100 Vejle, DenmarkDepartment of Biochemistry and Immunology, University Hospital of Southern Denmark, 6200 Aabenraa, DenmarkDepartment of Biochemistry and Immunology, Lillebælt Hospital—University Hospital of Southern Denmark, 6000 Kolding, DenmarkDepartment of Infectious Diseases, Odense University Hospital, 5000 Odense, DenmarkDepartment of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, DenmarkDepartment of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, DenmarkUrinary tract infections (UTIs) are a leading infectious cause of emergency department admission. Early UTI diagnosis is challenging, and a faster, preferably point-of-care urine analysis is necessary. We aimed to evaluate the diagnostic accuracy of urine flow cytometry (UFC) and urine dipstick analysis (UDA) in identifying bacteriuria and UTIs. This study included adults suspected of an infection admitted to three Danish emergency departments. UFC and UDA were the index tests, and urine culture and an expert panel diagnosis were the reference tests. We used logistic regression and receiver operator characteristics curves to find each test’s optimal model and cut-off. We enrolled 966 patients and performed urine cultures on 786. Urine culture was positive in 337, and 200 patients were diagnosed with a UTI. The UFC model ruled out bacteriuria in 10.9% with a negative predictive value (NPV) of 94.6% and ruled out UTI in 38.6% with an NPV of 97.0%. UDA ruled out bacteriuria in 52.1% with an NPV of 79.2% and UTI in 52.8% with an NPV of 93.9%. Neither UFC nor UDA performed well in ruling out bacteriuria in our population. In contrast, both tests ruled out UTI safely and in clinically relevant numbers.https://www.mdpi.com/2075-4418/14/4/412urinary tract infectionurine flow cytometryurine cultureurine dipstick analysisbacteriuriaurinalysis |
| spellingShingle | Mathias Amdi Hertz Isik Somuncu Johansen Flemming S. Rosenvinge Claus Lohman Brasen Eline Sandvig Andersen Claus Østergaard Thor Aage Skovsted Eva Rabing Brix Petersen Stig Lønberg Nielsen Christian Backer Mogensen Helene Skjøt-Arkil Urine Flow Cytometry and Dipstick Analysis in Diagnosing Bacteriuria and Urinary Tract Infections among Adults in the Emergency Department—A Diagnostic Accuracy Trial Diagnostics urinary tract infection urine flow cytometry urine culture urine dipstick analysis bacteriuria urinalysis |
| title | Urine Flow Cytometry and Dipstick Analysis in Diagnosing Bacteriuria and Urinary Tract Infections among Adults in the Emergency Department—A Diagnostic Accuracy Trial |
| title_full | Urine Flow Cytometry and Dipstick Analysis in Diagnosing Bacteriuria and Urinary Tract Infections among Adults in the Emergency Department—A Diagnostic Accuracy Trial |
| title_fullStr | Urine Flow Cytometry and Dipstick Analysis in Diagnosing Bacteriuria and Urinary Tract Infections among Adults in the Emergency Department—A Diagnostic Accuracy Trial |
| title_full_unstemmed | Urine Flow Cytometry and Dipstick Analysis in Diagnosing Bacteriuria and Urinary Tract Infections among Adults in the Emergency Department—A Diagnostic Accuracy Trial |
| title_short | Urine Flow Cytometry and Dipstick Analysis in Diagnosing Bacteriuria and Urinary Tract Infections among Adults in the Emergency Department—A Diagnostic Accuracy Trial |
| title_sort | urine flow cytometry and dipstick analysis in diagnosing bacteriuria and urinary tract infections among adults in the emergency department a diagnostic accuracy trial |
| topic | urinary tract infection urine flow cytometry urine culture urine dipstick analysis bacteriuria urinalysis |
| url | https://www.mdpi.com/2075-4418/14/4/412 |
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