Diagnostic Accuracy of Dipstick Assay in Prediction 0f Urinary Tract Infection (Uti)

Abstract

Background: Urinary Tract Infections (UTIs) are a common and pressing health concern, particularly in emergency department (ED) settings. Rapid and accurate diagnosis is crucial for effective treatment and management. While urine culture is the gold standard for UTI diagnosis, urine dipstick assays offer a quicker, more accessible alternative. Objective: The aim of this study was to evaluate the diagnostic accuracy of urine dipstick assays in comparison with urine culture for UTI detection in an ED setting. Methods: This study was conducted at the ED of Combined Military Hospital, Rawalpindi, from January to June 2023. A total of 260 patients, comprising 70.4% females and 29.6% males with a mean age of 44.45 ± 14.93 years, were included. The study employed a nonprobability consecutive sampling technique. Inclusion criteria were patients aged 18 to 75 years presenting with UTI symptoms and no recent UTI treatment history. Exclusion criteria included patients outside the specified age range, those with indwelling urinary catheters, and patients already under UTI treatment. Urine samples were tested using both dipstick analysis and culture. Sensitivity, specificity, and predictive values of the dipstick test were calculated and compared with culture results. Results: The sensitivity and specificity of the urine dipstick test were found to be 71% and 61.3%, respectively. The positive predictive value (PPV) was 68.4%, and the negative predictive value (NPV) was 64%. Of the 260 patients, 146 (56.2%) had positive dipstick results, while 141 (54.2%) had positive urine culture results. The study observed a higher prevalence of UTI in females, with 80.9% of positive cultures coming from female patients. Conclusion: Urine dipstick assays, with reasonable sensitivity and specificity, can serve as a rapid screening tool for UTIs in ED settings, especially in resource-limited environments. However, for definitive diagnosis, especially in cases of negative dipstick results, urine culture remains essential.