Performance of a urine-screening protocol.
The performance of a urinalysis protocol using screening Chemstrip-9 dipstick analysis with selective sediment microscopy and culture is reviewed. Sediment microscopy performed on urine samples positive for leukocyte esterase, nitrite, protein, or blood, or when specifically ordered (15% of urinalyses) was reduced by 57.1%. Protocol urine culture performed when more than 5 WBC/high-powered field (HPF), more than 10 bacteria/HPF, or yeasts were found on sediment microscopy or with a positive nitrite test was done for 9.8%. Urine culture was specifically ordered for another 13.6%. Percent significant bacteriuria (greater than or equal to 10(5) colony-forming units/mL) was higher for protocol-generated cultures (37.1%) versus ordered cultures (17.2%). For urinalyses with ordered cultures, the protocol would have detected 89.8% of cases with significant bacteriuria. The protocol has facilitated detection of significant bacteriuria with good acceptance by clinicians. Cost savings achieved by reduction of sediment microscopy was partly off-set by some increase in urine cultures performed.
D001437:Bacteriuria / Q000652:urine; D003365:Costs and Cost Analysis; D004950:Esterases / Q000652:urine; D005260:Female; D006417:Hematuria / Q000652:urine; D006801:Humans; D008297:Male; D008722:Methods; D008853:Microscopy; D009573:Nitrites / Q000652:urine; D011507:Proteinuria / Q000652:urine; D011786:Quality Control; D011933:Reagent Kits, Diagnostic; D014556:Urine / Q000032:analysis*
D009573:Nitrites; D011933:Reagent Kits, Diagnostic; D004950:Esterases