EVALUATION OF THE RAPID URINE DIPSTICK TEST AS A POINT OF CARE TEST IN THE DIAGNOSIS OF URINARY TRACT INFECTION IN A TERTIARY CARE HOSPITAL

Abstract

Background: Urinary tract infection is the most common bacterial infection, often seen in women, can cause severe morbidity and complications .Urinalysis is the unparelled way to rule out a urinary tract infection. The gold standard reference method for diagnosis of UTI is the urine culture which can help in diagnosing the pathogen and its antimicrobial susceptibility pattern in 48 hrs.  Furthermore, urine culture is a high priced procedure for the patient and needs a well equipped microbiology laboratory with expertise. So there is a need for evaluating the efficacy of rapid dipstick tests which are less time-consuming, less expensive, no required expertise and well equipped laboratory.

Materials and methods: A retrospective study was conducted in the Dept. of Microbiology of our tertiary care centre for urine specimens received between January to June 2018. A total 1204 samples were received in Microbiology laboratory. Two Clean catch, Mid-Stream Urine (MSU) samples with suspicion of UTI, were collected in sterile container and tested for LE and NIT by using Reagent strip (SIEMENS URISTIX).Urine culture was performed by standard loop method on CLED agar.

Results: Diagnostic measures i.e. sensitivity, specificity, PPV and NPV were calculated by standard formulas using culture as gold standard. The diagnostic accuracy of combination tests Leucocyte esterase (LE) and Nitrate reductase (NIT) was more compared to individual tests LE and NIT.

Conclusion: A combination of LE and NIT test appears to be a useful indicator for the diagnosis of UTI.

Keywords: Urine culture, urine dipstick test, urinary tract infection, point of care test