Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-26T19:30:37.719Z Has data issue: false hasContentIssue false
  • English
  • Français

Role of Dipstick Testing in the Evaluation of Urinary Tract Infection in Nursing Home Residents

Published online by Cambridge University Press:  02 January 2015

Manisha Juthani-Mehta ,
Mary Tinetti ,
Eleanor Perrelli ,
Virginia Towle  and
Vincent Quagliarello
Manisha Juthani-Mehta*
Affiliation:
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
Mary Tinetti
Affiliation:
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
Eleanor Perrelli
Affiliation:
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
Virginia Towle
Affiliation:
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
Vincent Quagliarello
Affiliation:
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
*
Yale University School of Medicine, Department of Internal Medicine, Section of Infectious Disease, LMP 5040A, P.O. Box 208022, New Haven, CT 06520 (manisha.juthanimehta@yale.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Among 101 nursing home residents with suspected urinary tract infection (UTI), we determined the negative predictive value of dipstick testing for leukocyte esterase and nitrite to be 100% (95% confidence interval, 74%-100%), compared with laboratory evidence of UTI (greater than 10 white blood cells/mm3 on urinalysis and greater than 100,000 colony forming units/mL on urine culture). Nursing home dipstick testing effectively excluded the possibility of UTI.

Type
Concise Communications
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 7 , July 2007 , pp. 889 - 891
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Ouslander, JG, Schapira, M, Fingold, S, Schnelle, J. Accuracy of rapid urine screening tests among incontinent nursing home residents with asymptomatic bacteriuria. J Am Geriatr Soc 1995;43:772–775.Google Scholar
2.Juthani-Mehta, M, Drickamer, MA, Towle, V, Zhang, Y, Tinetti, ME, Quag-liarello, VJ. Nursing home practitioner survey of diagnostic criteria for urinary tract infections. J Am Geriatr Soc 2005;53:1986–1990.Google Scholar
3.Gradwohl, SE, Chenoweth, CE, Fonde, KR, Van Harrison, R, Zoschnick, LB. UMHS Urinary Tract Infection Guideline. Regents of the University of Michigan, 2005. Available at: http://cme.med.umich.edu/pdf/guideline/UTI05.pdf. Accessed October 3, 2006.Google Scholar
4.Lachs, MS, Nachamkin, I, Edelstein, PH, Goldman, J, Feinstein, AR, Schwartz, JS. Spectrum bias in the evaluation of diagnostic tests: lessons from the rapid dipstick test for urinary tract infection. Ann Intern Med 1992;117:135–140.Google Scholar
5.Flanagan, PG, Rooney, PG, Davies, EA, Stout, RW. Evaluation of four screening tests for bacteriuria in elderly people. Lancet 1989;1:1117–1119.Google Scholar
6.Evans, PJ, Leaker, BR, McNabb, WR, Lewis, RR. Accuracy of reagent strip testing for urinary tract infection in the elderly. J R Soc Med 1991;84:598–599.Google Scholar
7.Midthun, S, Bruce, AW. Are true-negative nitrite results affected by a two-hour delay in dipstick/pad analysis of urine in incontinence pads? J Wound Ostomy Continence Nurs 2006;33:292–295.Google Scholar
8.Midthun, SJ, Paur, RA, Lindseth, G, Von Duvillard, SP. Bacteriuria detection with a urine dipstick applied to incontinence pads of nursing home residents. Geriatr Nurs 2003;24:206–209.Google Scholar
9.Ouslander, JG, Schapira, M, Schnelle, IF, Fingold, S. Pyuria among chronically incontinent but otherwise asymptomatic nursing home residents. J Am Geriatr Soc 1996;44:420–423.Google Scholar
10.Monane, M, Gurwitz, JH, Lipsitz, LA, Glynn, RJ, Choodnovskiy, I, Avorn, J. Epidemiologic and diagnostic aspects of bacteriuria: a longitudinal study in older women. J Am Geriatr Soc 1995;43:618–622.Google Scholar
11.Garner, IS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128–140.CrossRefGoogle ScholarPubMed
12.Stamm, WE. Measurement of pyuria and its relation to bacteriuria. Am J Med 1983;75:53–58.Google Scholar
13.Deville, WL, Yzermans, JC, van Duijn, NP, Bezemer, PD, van der Windt, DA, Bouter, LM. The urine dipstick test useful to rule out infections: a meta-analysis of the accuracy. BMC Urol 2004;4:4.Google Scholar
14.Midthun, S. Bruce, AW. The Clinical Laboratory Improvement Amendment: how it applies to the use of urine dipsticks in the long-term care facility. Geriatric Nursing 2005;26:309–316.Google Scholar