Assessment of urine analysis for the diagnosis of tuberculosis

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Abstract
In this retrospective study, conducted between July 1983 and July 1993 in a 500 bed hospital, all patients with positive urine cultures for M tuberculosis were identified from microbiology records. During this 10 year period, 7200 midstream morning urine specimens obtained from 2814 patients (mean (SD) age 48.9 (22.9) years; 63% male) were submitted to microbiological examination for a presumptive diagnosis of tuberculosis. All urine specimens were inoculated onto Lowenstein-Jensen medium. Only 65 (0.9%) urine samples obtained from 33 patients (1.2%) yielded positive cultures for M tuberculosis. In this group, acid fast bacilli in direct Ziehl-Nielsen stained smears were detected in eight of the 19 samples processed. Urine analysis performed on non-centrifuged samples of 29 of these 33 patients gave normal results for 21 of them, including three of the seven patients with genitourinary tuberculosis. The urinary sediment of the remaining patients showed pyuria (>/=10000 cells/ml) in all eight and haematuria (>/=5000 cells/ml) in five.