Document Type: Original Article

Authors

1 Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Emergency Medicine, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran

Abstract

Objective: The purpose of this study is to evaluate the diagnostic value of nitrite test in comparison with urine culture (U/C) results in patients with Urinary tract infection (UTI) symptoms.
Methods: This cross-sectional study was performed on 203 patients with UTI symptoms. Middle urine sample was taken into sterile plastic containers, and simultaneously the urine sample and the nitrite test were done by the use of urine dipstick test. Data were analyzed using SPSS software version 23.
Results: The results of the urine culture test indicated that the highest excreted organisms in both sexes were E. coli (58.8%), Candida (17.6%), Klebsiella (8.8%), E. coli (MDR) (5.9%), Pseudomonas (2.9%), Enterococcus (2.9%) and Acinetobacter (2.9%). The results showed that there was a significant correlation between U/C and urine analysis (U/A) test results (P = 0.01), and in U/C positive results, U/A results were significantly positive for UTI. Other findings showed a significant relationship between the results of nitrite one and nitrite two tests (P = 0.001). There was a significant correlation between urinary, and nitrite1 levels (P = 0.04). Also, in this study, the sensitivity and specificity of diagnostic tests for U/A and nitrite 1 and 2 with U/C were calculated as the Golden Standard method.
Conclusion: Overall, the results of this study showed that the negative nitrite test and urine dipstick test could be performed in emergency cases to prevent ectopic dysfunction and inadequate diagnosis. Also, it can reduce the unreasonable expenses for U/A.

Keywords

Main Subjects

1. Okorocha I, Cumming G, Gould I. Female urodynamics and lower urinary tract infection. BJU Int 2002; 89(9): 863-
7. doi: 10.1046/j.1464-410x.2002.02770.x.
2. Mims CA, Dockrell HM,Goring RV, Roitt I, WakelinD, Zuckerman M. Medical Microbiology. 3rd ed. London: Mosbey Co; 2004.
3. Bailey RR. Uncomplicated acute pyelonephritis. In: Bergan T, ed. Urinary Tract Infections. Basel: Karger; 1997. p. 14-8. doi: 10.1159/000061392.
4. Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Dis Mon 2003; 49(2): 53-70. doi: 10.1067/mda.2003.7.
5. Schaechter M, Engleberg NC, Eisenstein B, Medoff G. Mechanism of Microbial Disease. 3rd ed. Baltimore: Williams and Wilkins; 1998.
6. Schumann GB, Schweitzer SC. Examination of urine. In: Henry JB, ed. Clinical Diagnosis and Management by Laboratory Methods. 18th ed. Philadelphia: Saunders; 1991. p. 387-444.

7. Soltan Dalal MM, Hafezi R. Relation between urine culture and cytology in urinary tract infections. Teb va Tazkieh
1999; 8(2): 9-15. [In Persian].
8. Sheikh N , Yousefi Mashouf R. A survey on the predictive value of leukocyturia, Nitrite test and bacteriuria in urinary
tract infections (UTI) in children under ten years old in Hamadan. The Iranian Journal of Urology 2002; 9 (34): 36-
31. [In Persian].
9. Mirmahdavi F, Ahmadian A. Common bacteria causing urinary tract infections and introducing the sensitivity of
isolated bacteria to common antibiotics. Medical Journal of Tabriz University of Medical Sciences 2000; 34(48): 53-8.
[In Persian].
10. Koneman EW, Allen SD, Janda WM. Diagnostic Microbiology. 12th ed. Philladelphia: JB Lippincott, Williams & Wilkins; 1997.
11. Platt R. Quantitative definition of bacteriuria. Am J Med 1983; 75(1B): 44-52. doi: 10.1016/0002-9343(83)90072-4.
12. Asscher AW. Urinary Tract Infection. Lancet 1974; 2(7893): 1365-7. doi: 10.1016/s0140-6736(74)92230-2.
13. Ghadiri Mofrad J. Determining the type of microorganisms causing urinary tract infection and drug resistance pattern in patients admitted to hospitals affiliated to Shahid Sadoughi University of Medical Sciences, Yazd [dissertation]. Yazd:
Shahid Sadoughi University; 1993. [In Persian].
14. Murray PR, Rosenthal KS, Pfaller MA. Medical Microbiology. 4th ed. St Louis: Elsevier Mosby; 2005. p. 86-91.
15. Kayalp D, Dogan K, Ceylan G, Senes M, Yucel D. Can routine automated urinalysis reduce culture requests? Clin Biochem 2013; 46(13-14): 1285-9. doi: 10.1016/j.clinbiochem.2013.06.015.
16. Lenke RR, Van Dorsten JP. The efficacy of the nitrite test and microscopic urinalysis in predicting urine culture
results. Am J Obstet Gynecol 1981; 140(4): 427-9. doi:10.1016/0002-9378(81)90039-9.
17. Najeeb S, Munir T, Rehman S, Hafiz A, Gilani M, Latif M. Comparison of urine dipstick test with conventional
urine culture in diagnosis of urinary tract infection. J Coll Physicians Surg Pak 2015; 25(2): 108-10.
18. Ninama AB, Shah PD. Comparison of various screening methods for presumptive diagnosis of significant bacteriuria. Int J Med Sci Public Health 2016; 5(6): 1066-9. doi: 10.5455/ijmsph.2016.12092015167.