Predictive value of the urinary dipstick test in the management of patients with urinary tract infection-associated symptoms in primary care in Indonesia: A cross-sectional study

F. Ginting, A.K. Sugianli, R.L. Kusumawati, I. Parwati, M.D. De Jong, C. Schultsz, F. Van Leth

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Objective To assess the test characteristics of a urine dipstick test in predicting a positive urine culture in an outpatient setting in Indonesia. Design Cross-sectional study. Setting Two outpatient clinics in Medan, Indonesia. Participants 616 consecutively enrolled participants suspected of having a urinary tract infection. Outcome measures The primary outcome is the estimates of accuracy (sensitivity, specificity, predictive values) where urine culture is the reference test. The secondary outcome is the post-test probability of a positive urine culture. Results The optimal test characteristics were obtained when index test positivity was defined as any leucocyte esterase reaction and/or a nitrite reaction and reference test positivity was defined as a urine culture with a growth of at least 10 3 colony-forming units/mL (sensitivity: 88.2% (95% CI 81.6 to 93.1), negative predictive value: 93.0% (95% CI 88.9 to 95.9)). The post-test probability of a positive urine culture after a negative urinary dipstick test was 7% in the obstetric/gynaecology clinic and 8% in the internal medicine clinic. Conclusion The use of a urine dipstick test in a rule-out strategy can reduce the need for urine culture and avoid the prescription of (ineffective) antibiotics in a non-urology outpatient setting.
Original languageEnglish
Article numbere023051
JournalBMJ Open
Volume8
Issue number8
DOIs
Publication statusPublished - 1 Aug 2018
Externally publishedYes

Funding

Funding The study was funded through a grant from the Royal Netherlands Academy of Arts and Science as part of the Scientific Program Indonesia-the Netherlands (SPIN). The funding source did not have any role in the design and implementation of the study, the writing of the manuscript, or the decision to publish.

FundersFunder number
Royal Netherlands Academy of Arts and Science

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