Rapid Nitrite Dip Stick Vs Urine culture for diagnosis of Urinary tract Infections (UTI): Laboratory prospective

Abstract

Background: Urinary tract infection common bacterial disease with all age group causing lower to complicated UTI leading to life threatening condition urosepsis. Urine culture is gold standard however urine dipstick test can help in early detection of UTI by avoiding the complication of UTI. The study aims to compare the diagnostic accuracy of rapid nitrate dip stick test with urine culture and identify the common uropathogens and their antimicrobial susceptibility pattern. Materials and Methods: Clean catch mid stream urine samples from suspected cases of UTI were evaluated by rapid nitrate dip stick and culture. The culture isolates were identified and antimicrobial susceptibility test was performed following Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Total of 202 urine specimens evaluated, out of which 46(22.77%) were positive for rapid nitrate dip stick test, but 42(20.79%) were culture positive. Among the culture positives, nitrate test was positive in 29(69.04%). Gram-negative bacilli were predominant (95.25%), Escherichia coli (21) being most frequent isolate followed by Enterobacter (6), Klebsiella (5) and Acinetobacter (3). The GNB were mostly susceptible to imipenam (75%), amikacin (62.5%) and cotrimoxazole 45%. The overall sensitivity, specificity, positive and negative predictive values of nitrite test in relation to culture were calculated to be 69.04%, 89.4%, 63.0% and 91.6%, respectively but the value of pyuria in relation to culture was 36%, 60%, 68% and 55%, respectively. Conclusion: The study reveals that the rapid nitrate dip stick test can be used in conjunction with urine culture for diagnosis of UTI but cannot replace it entirely.