Performance of Urinalysis Parameters in Predicting Urinary Tract Infection: Does One Size Fit all?

Sonali D Advani; Rebecca North; Nicholas A Turner; Sahra Ahmadi; Julia Denniss; Adero Francis; Rachel Johnson; Anum Hasan; Faryal Mirza; Sarah Pardue; Meghana Rao; Yasmin Rosshandler; Helen Tang; Kenneth E Schmader; Deverick J Anderson

doi:10.1093/cid/ciae230

Performance of Urinalysis Parameters in Predicting Urinary Tract Infection: Does One Size Fit all?

Clin Infect Dis. 2024 Apr 26:ciae230. doi: 10.1093/cid/ciae230. Online ahead of print.

Authors

Affiliations

¹ Duke Center for Antimicrobial Stewardship and Infection Prevention, Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, United States.
² Duke Center for the Study of Aging and Human Development, Durham, NC, United States.
³ Department of Medicine, WellStar Health System, Atlanta, GA, United States.
⁴ Department of Medicine, Duke University School of Medicine, Durham, NC, United States.
⁵ Department of Medicine, Sovah Medical Center, Danville, VA, United States.
⁶ Division of Geriatrics, Department of Medicine, Duke and Durham VA Medical Center, Durham, NC, United States.

PMID: 38666412
DOI: 10.1093/cid/ciae230

Abstract

In a multi-hospital cohort study of 3392 patients, positive urinalysis parameters had poor positive predictive value for diagnosing urinary tract infection (UTI). Combined urinalysis parameters (pyuria or nitrite) performed better than pyuria alone for ruling out UTI. However, performance of all urinalysis parameters was poor in older women.

Keywords: leukocyte esterase; nitrite; pyuria; reflex urine cultures.

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