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Sensitivity and specificity of the urine nitrite test and gram staining in diagnosing UTIs in children
Published in Cut Adeya Adella, Stem Cell Oncology, 2018
N. Fidelia, R. Ramayanti, S. Nafianti, Rusdidjas, O.R. Ramayani, R.S. Siregar, B. Siregar
This study showed that the sensitivity and specificity of gram staining are high. The nitrite test showed high specificity. The nitrite test and gram urine staining are good alternative diagnostic and screening tests for UTIs in children in areas with limited facilities and health workers.
Chemical hazards *
Published in Jamie Bartram, Rachel Baum, Peter A. Coclanis, David M. Gute, David Kay, Stéphanie McFadyen, Katherine Pond, William Robertson, Michael J. Rouse, Routledge Handbook of Water and Health, 2015
Lisa Smeester, Andrew E. Yosim, Rebecca C. Fry
Reducing exposure to nitrate from drinking water generally includes management of activities within the watershed/aquifer to control agricultural inputs, treatment to decrease nitrate levels in the water supply, and management of nitrification in the distribution system. Wells that are located in agricultural areas are susceptible to nitrate and nitrite contamination, particularly shallow wells. Water containing levels of nitrate and/or nitrite above guideline levels should not be used to prepare formula or other foods for infants. For wells that persistently have nitrate or nitrite test results above guideline or regulatory levels, installing a drinking water treatment device, using an alternative drinking water source, or relocating or drilling a deeper well to reach a safe supply should be considered (Health Canada, 2013).
Proteinuria in Pregnancy
Published in Tony Hollingworth, Differential Diagnosis in Obstetrics and Gynaecology: An A-Z, 2015
Peter Muller, Rachel Wooldridge
Urinary protein is increased in urinary tract infections, and this should be excluded in all cases. In pregnant women, both nitrites and leucocyte esterase on the urine dipstick have a low sensitivity but high specificity for urinary tract infection. Therefore, if both are negative, infection can be ruled out.9 A positive nitrite test needs further investigation with microscopy, culture, and sensitivity of a midstream urine specimen.
Neutrophil Gelatinase-Associated Lipocalin (NGAL) and cystatin C are early biomarkers of acute kidney injury associated with cardiac surgery
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2022
Anne Cecilie K. Larstorp, Cathrin Lytomt Salvador, Bjørn Andreas Svensvik, Olav Klingenberg, Sonia Distante
Our study has limitations. First, the small number of included patients (n = 49) and a limited number of AKI endpoints (n = 9), did not make grading of AKI feasible. Second, given the small sample size, the study is prone to type 2 errors, e.g. forty-eight hours postoperatively the AKI group tended to higher P-NGAL and P-cystatin C, but the differences were not significant (p-values .08 and .08). Third, some of the patients in our study were administered Solumedrol postoperatively. Glucocorticoids can induce the promotor of the cystatin C gene and increase the concentration of plasma cystatin C in a dose-dependent way [25]. Finally, we did not collect data on urine output and fluid treatment perioperatively. Of note, there are different NGAL cut-offs in the literature, probably due to different patient cohorts, study protocols, times of sampling and assays for measurement. Another weakness of the biomarker is that inflammation, infections and malignancy can induce secretion of NGAL [26]. All patients in our study had a negative urine dipstick nitrite test and nearly 96% of patients had CRP ≤40 mg/L. Overt sepsis was an exclusion criterion. Future studies should include data on urine output and fluid treatment during surgery and immediately postoperatively to improve the interpretation of results.
Prevalence, impact, and management strategies for asymptomatic bacteriuria in the acute care elderly patient: a review of the current literature
Published in Expert Review of Anti-infective Therapy, 2020
Zvi Shimoni, Regev Cohen, Paul Froom
Although the dipstick test is generally precise and sensitive [32,35], there are estimations from a meta-analysis, that the sensitivity in detecting a UTI in the elderly is only 82% (95% CI, 74%–92%) [36]. The interpretation of the studies included in the meta-analysis is however problematic because of differences in the definitions of a UTI, variable performances of the dipstick, and differences in defining the cutoff for a positive urine culture. More recently one study reported that a trace leukocyte esterase and/or positive nitrite test on dipstick identified 96.9% of the elderly patients with a bacteremic UTI [32] and two studies reported positive dipsticks in 90.1% and 92% of those with isolated bacteriuria [37,38]. The nitrite test is generally more specific than the leukocyte esterase but has a lower sensitivity to detect a bacteremic UTI [32] and cannot be used alone to rule out a UTI. The determination of the precision and sensitivity of dipstick testing, however, needs to be done locally before making clinical decisions based on the results.
Current practice on the management of pre-operative urine dipstick results in women undergoing gynaecological surgery in Wales
Published in Journal of Obstetrics and Gynaecology, 2019
Sarah Walker, Catharina Bisseling, Sanjay Curpad, Gareth Edwards
The debate regarding the most appropriate diagnostic test for UTI and how to manage a positive result is ongoing. The urine dipstick is a screening test for UTI and its sensitivity and specificity varies (Deville et al. 2004). Mambatta et al. (2015) conclude that the sensitivity of the urine dipstick nitrite test and leukocyte-esterase (LE) test, when used in isolation, was low and cannot rule out UTI in most patients. Urine culture is therefore suggested for all patients with a suspected UTI (John et al. 2006). Furthermore, the Scottish intercollegiate guideline network (SIGN) number 88 on management of suspected bacterial UTI in adults, suggests the gold standard for the diagnosis of UTI is culture of bladder urine obtained by needle aspiration as it minimises the risk of contamination of urine specimen. All other techniques (urethral catheter and midstream specimens of urine) carry a higher risk of contamination with high false positive rates (SIGN 88 2012). Likewise, clinical guidance from the National Institute for health and Care Excellence (NICE) does not recommend the use of urine dipsticks pre-operatively in routine surgery. Instead, NICE recommends considering microscopy and culture of midstream urine sample if the presence of a UTI would influence the decision whether or not to operate (NICE CG 171 2015). This further demonstrates the lack of evidence for routine urine dipstick testing on the day of gynaecological surgery.