Original scientific paper

https://doi.org/10.11613/BM.2013.025

Diagnostic accuracy of UriSed automated urine microscopic sediment analyzer and dipstick parameters in predicting urine culture test results

Kağan Huysal ; Department of Clinical Laboratory, Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
Yasemin U. Budak ; Department of Clinical Laboratory, Sevket Yilmaz Education and Research Hospital, Bursa, Turkey
Ayse Ulusoy Karaca ; Department of Clinical Microbiology, Sevket Yilmaz Education and Research Hospital, Bursa, Turkey
Murat Aydos ; Department of Urology, Sevket Yilmaz Education and Research Hospital, Bursa, Turkey
Serdar Kahvecioğlu ; Department of Nephrology, Sevket Yilmaz Education and Research Hospital, Bursa, Turkey
Mehtap Bulut ; Department of Emergency Medicine, Sevket Yilmaz Education and Research Hospital, Bursa, Turkey
Murat Polat ; Department of General Surgery, Sevket Yilmaz Education and Research Hospital, Bursa, Turkey

Abstract

Introduction: Urinary tract infection (UTI) is one of the most common types of infection. Currently, diagnosis is primarily based on microbiologic culture, which is time- and labor-consuming. The aim of this study was to assess the diagnostic accuracy of urinalysis results from UriSed (77 Electronica, Budapest, Hungary), an automated microscopic image-based sediment analyzer, in predicting positi-ve urine cultures.
Materials and methods: We examined a total of 384 urine specimens from hospitalized patients and outpatients attending our hospital on the same day for urinalysis, dipstick tests and semi-quantitative urine culture. The urinalysis results were compared with those of conventional semi-quantitative urine culture.
Results: Of 384 urinary specimens, 68 were positive for bacteriuria by culture, and were thus consi-dered true positives. Comparison of these results with those obtained from the UriSed analyzer indi-cated that the analyzer had a specificity of 91.1%, a sensitivity of 47.0%, a positive predictive value (PPV) of 53.3% (95% confidence interval (CI) = 40.8-65.3), and a negative predictive value (NPV) of 88.8% (95% Cl = 85.0-91.8%). The accuracy was 83.3% when the urine leukocyte parameter was used, 76.8% when bacteriuria analysis of urinary sediment was used, and 85.1% when the bacteriuria and leukocyturia parameters were combined. The presence of nitrite was the best indicator of culture positivity (99.3% specificity) but had a negative likelihood ratio of 0.7, indicating that it was not a relia-ble clinical test.
Conclusions: Although the specificity of the UriSed analyzer was within acceptable limits, the sensitivity value was low. Thus, UriSed urinalysis results do not accurately predict the outcome of culture.

Keywords

urinalysis; bacteriuria; sensitivity; specificity; urinary tract infection

Hrčak ID:

103797

URI

https://hrcak.srce.hr/103797

Publication date:

15.6.2013.

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