Can the Urine Dipstick Test Be an Alternative in the Screening of Urinary Tract Infections for Inpatients in the Context of a Low-Income Country?  

作　　者：André Nagalo Odilon D. Kaboré Senkaye-Lagom Aimée Kissou Hervé Kafando Boukary Kabré Emmanuel Zongo Cheick Ahmed Ouattara Yacouba Sawadogo Aoua Semdé Jacques Zoungrana Armel Poda Sylvain Godreuil Abdoul-Salam Ouédraogo André Nagalo;Odilon D. Kaboré;Senkaye-Lagom Aimée Kissou;Hervé Kafando;Boukary Kabré;Emmanuel Zongo;Cheick Ahmed Ouattara;Yacouba Sawadogo;Aoua Semdé;Jacques Zoungrana;Armel Poda;Sylvain Godreuil;Abdoul-Salam Ouédraogo(Bacteriology-Virology Laboratory, Sourô, Sanou University Hospital, Bobo-Dioulasso, Burkina Faso;Biomedical Analysis Laboratory, Regional University Hospital of Ouahigouya, Ouahigouya, Burkina Faso;Department of Medical Pediatrics, Sourô, Sanou University Hospital, Bobo-Dioulasso, Burkina Faso;Bacteriology-Virology Laboratory, Yalgado Ouedraogo University Hospital, Ouagadougou, Burkina Faso;Department of Urology-Andrology, Regional Hospital of Tenkodogo, Tenkodogo, Burkina Faso;Information, Epidemiology, Research and Planning Department, Sourô, Sanou University Hospital, Bobo-Dioulasso, Burkina Faso;Department of Nephrology-Hemodialysis, Sourô, Sanou University Hospital, Bobo-Dioulasso, Burkina Faso;Department of Infectious Diseases, Sourô, Sanou University Hospital, Bobo-Dioulasso, Burkina Faso;Laboratory of Bacteriology of the Arnaud de Villeneuve University Hospital, Montpellier, France)

机构地区：[1]Bacteriology-Virology Laboratory, Sourô, Sanou University Hospital, Bobo-Dioulasso, Burkina Faso [2]Biomedical Analysis Laboratory, Regional University Hospital of Ouahigouya, Ouahigouya, Burkina Faso [3]Department of Medical Pediatrics, Sourô, Sanou University Hospital, Bobo-Dioulasso, Burkina Faso [4]Bacteriology-Virology Laboratory, Yalgado Ouedraogo University Hospital, Ouagadougou, Burkina Faso [5]Department of Urology-Andrology, Regional Hospital of Tenkodogo, Tenkodogo, Burkina Faso [6]Information, Epidemiology, Research and Planning Department, Sourô, Sanou University Hospital, Bobo-Dioulasso, Burkina Faso [7]Department of Nephrology-Hemodialysis, Sourô, Sanou University Hospital, Bobo-Dioulasso, Burkina Faso [8]Department of Infectious Diseases, Sourô, Sanou University Hospital, Bobo-Dioulasso, Burkina Faso [9]Laboratory of Bacteriology of the Arnaud de Villeneuve University Hospital, Montpellier, France

出　　处：《Advances in Infectious Diseases》2023年第4期627-640,共14页传染病进展（英文）

摘　　要：Background: Urinary Tract Infection (UTI), a prevalent bacterial infection in adults, heavily relies on cytobacteriological examination of urine (CBEU) for diagnosis. However, in resource-limited countries, accessibility to CBEU remains hindered by cost and availability. This study aims to assess the utility of the Urinary Dipstick Test (UDT) in diagnosing UTIs among hospitalized patients in the context of limited resources. Methods: A cross-sectional study was conducted from February to May 2019, encompassing hospitalized patients who underwent CBEU at the bacteriology unit of Sour? Sanou University Hospital. UDT and CBEU were concurrently performed, and UDT’s analytical and diagnostic performance was evaluated against CBEU, considered the gold standard. Results: A total of 274 CBEU requests were registered, involving 274 patients (159 males) with a mean age of 45.8 ± 21.3 years (ranging from 1 to 90 years). UTI was confirmed in 90 patients, yielding a frequency of 32.85%. The UTI bacteriological profile was dominated by Enterobacteriaceae (75.23%), primarily Escherichia coli (60.55%). Nitrite and Leukocytes were positive in 54 (19.8%) and 157 (53.6%) of the samples tested. Among patients with confirmed UTI, Nitrite, and Leukocytes were positive in 30 (33%) and 71 (79%) patients respectively. UDT demonstrated variable performance based on nitrite and leukocyte combination: Sensitivity (57%-82%), Specificity (7%-98%), Positive Predictive Value (PPV) (43%-57%), Negative Predictive Value (NPV) (43%-67%). UDT performed slightly better in women (NPV = 88%) and inpatients without urinary catheters (NPV = 75% and PPV = 80%). Conclusion: This study underscores UDT’s potential utility in excluding UTIs among women, younger patients, and inpatients without urinary catheters, albeit with limited confidence. The UDT emerges as a complementary tool for UTI screening, particularly in resource-limited settings.Background: Urinary Tract Infection (UTI), a prevalent bacterial infection in adults, heavily relies on cytobacteriological examination of urine (CBEU) for diagnosis. However, in resource-limited countries, accessibility to CBEU remains hindered by cost and availability. This study aims to assess the utility of the Urinary Dipstick Test (UDT) in diagnosing UTIs among hospitalized patients in the context of limited resources. Methods: A cross-sectional study was conducted from February to May 2019, encompassing hospitalized patients who underwent CBEU at the bacteriology unit of Sour? Sanou University Hospital. UDT and CBEU were concurrently performed, and UDT’s analytical and diagnostic performance was evaluated against CBEU, considered the gold standard. Results: A total of 274 CBEU requests were registered, involving 274 patients (159 males) with a mean age of 45.8 ± 21.3 years (ranging from 1 to 90 years). UTI was confirmed in 90 patients, yielding a frequency of 32.85%. The UTI bacteriological profile was dominated by Enterobacteriaceae (75.23%), primarily Escherichia coli (60.55%). Nitrite and Leukocytes were positive in 54 (19.8%) and 157 (53.6%) of the samples tested. Among patients with confirmed UTI, Nitrite, and Leukocytes were positive in 30 (33%) and 71 (79%) patients respectively. UDT demonstrated variable performance based on nitrite and leukocyte combination: Sensitivity (57%-82%), Specificity (7%-98%), Positive Predictive Value (PPV) (43%-57%), Negative Predictive Value (NPV) (43%-67%). UDT performed slightly better in women (NPV = 88%) and inpatients without urinary catheters (NPV = 75% and PPV = 80%). Conclusion: This study underscores UDT’s potential utility in excluding UTIs among women, younger patients, and inpatients without urinary catheters, albeit with limited confidence. The UDT emerges as a complementary tool for UTI screening, particularly in resource-limited settings.

关 键 词：Urine Dipstick Test Urinary Tract Infection LMICs Burkina Faso 

分 类 号：R73[医药卫生—肿瘤]