TY - JOUR
T1 - Predictive value of the urinary dipstick test in the management of patients with urinary tract infection-associated symptoms in primary care in Indonesia: A cross-sectional study
T2 - A cross-sectional study
AU - Ginting, Franciscus
AU - Sugianli, Adhi Kristianto
AU - Kusumawati, R. Lia
AU - Parwati, Ida
AU - de Jong, Menno D.
AU - Schultsz, Constance
AU - van Leth, Frank
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Objective To assess the test characteristics of a urine dipstick test in predicting a positive urine culture in an outpatient setting in Indonesia. Design Cross-sectional study. Setting Two outpatient clinics in Medan, Indonesia. Participants 616 consecutively enrolled participants suspected of having a urinary tract infection. Outcome measures The primary outcome is the estimates of accuracy (sensitivity, specificity, predictive values) where urine culture is the reference test. The secondary outcome is the post-test probability of a positive urine culture. Results The optimal test characteristics were obtained when index test positivity was defined as any leucocyte esterase reaction and/or a nitrite reaction and reference test positivity was defined as a urine culture with a growth of at least 10 3 colony-forming units/mL (sensitivity: 88.2% (95% CI 81.6 to 93.1), negative predictive value: 93.0% (95% CI 88.9 to 95.9)). The post-test probability of a positive urine culture after a negative urinary dipstick test was 7% in the obstetric/gynaecology clinic and 8% in the internal medicine clinic. Conclusion The use of a urine dipstick test in a rule-out strategy can reduce the need for urine culture and avoid the prescription of (ineffective) antibiotics in a non-urology outpatient setting.
AB - Objective To assess the test characteristics of a urine dipstick test in predicting a positive urine culture in an outpatient setting in Indonesia. Design Cross-sectional study. Setting Two outpatient clinics in Medan, Indonesia. Participants 616 consecutively enrolled participants suspected of having a urinary tract infection. Outcome measures The primary outcome is the estimates of accuracy (sensitivity, specificity, predictive values) where urine culture is the reference test. The secondary outcome is the post-test probability of a positive urine culture. Results The optimal test characteristics were obtained when index test positivity was defined as any leucocyte esterase reaction and/or a nitrite reaction and reference test positivity was defined as a urine culture with a growth of at least 10 3 colony-forming units/mL (sensitivity: 88.2% (95% CI 81.6 to 93.1), negative predictive value: 93.0% (95% CI 88.9 to 95.9)). The post-test probability of a positive urine culture after a negative urinary dipstick test was 7% in the obstetric/gynaecology clinic and 8% in the internal medicine clinic. Conclusion The use of a urine dipstick test in a rule-out strategy can reduce the need for urine culture and avoid the prescription of (ineffective) antibiotics in a non-urology outpatient setting.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85052756894&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30158234
U2 - https://doi.org/10.1136/bmjopen-2018-023051
DO - https://doi.org/10.1136/bmjopen-2018-023051
M3 - Article
C2 - 30158234
SN - 2044-6055
VL - 8
JO - BMJ Open
JF - BMJ Open
IS - 8
M1 - e023051
ER -