Predicting Urine Culture Results: The Comparative Values of Nitrituria, Leukocyturia, and Microscopic Bacteriuria

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Abstract
Nitrituria, leukocyturia, and microscopic bacteriuria were determined for 141 consecutive culture-positive and 111 consecutive culture-negative urines collected by a midstream clean-catch method to assess the value of these tests in the prediction of urine culture positivity. The microscopic quantitation of urine bacteria is a more sensitive indicator of urine culture positivity than nitrituria or leukocyturia, either alone or in combination. By including urines whose microscopic examination for bacteriuria was obscured (by massive leukocyturia, excessive amorphous debris, or formed elements) among those selected as "probably culture positive" on the basis of bacteriuria alone, the sensitivity of the microscopic examination was 99% and its specificity was 72%. Under the conditions of this study, urine microscopy offers the superior method of screening urines for urinary tract infections.

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