Cost-effective screening for urinary tract infections in urogynaecological patients.
This study aims to test the cost-effectiveness of reagent-strip urine nitrite compared with microbiological laboratory testing for screening of urinary tract infections (UTI). The study is a retrospective review of 708 female patients who underwent cystometry during a 1-year period. Urine dipstick nitrite was used as a screening test for UTI while urine cultures were taken as an outcome. Symptoms of UTI were noted. Of 708 patients screened, 70 (9.9%) had a significant UTI. Only 32 (4.5%)of 708 patients were nitrite positive. Urine dipstick nitrite has sensitivity of 40%, specificity of 99%, positive predictive value (PPV) of 88 % and negative predictive value (NPV) of 94%. If the screening test included symptoms for UTI together with urine nitrite, the results are: sensitivity 89%, specificity 31%, PPV 12% and NPV 96%. A combination of screening with urine nitrite and UTI symptoms can increase sensitivity to 89%. A total of 29% of specimens (screen negative=nitrite negative/asymptomatic) can then be excluded from UFEME/culture testing, thus resulting in cost savings.
Wong
H F
HF
Uro-gynaecological Unit, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore. wong.heng.fok@singhealth.com.sg
Lee
L C
LC
Han
H C
HC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D003937:Diagnosis, Differential; D005260:Female; D006176:Gynecology / Q000379:methods*; D006801:Humans; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012846:Singapore / Q000453:epidemiology; D016482:Urinalysis / Q000191:economics / Q000379:methods; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000453:epidemiology; D014572:Urology / Q000379:methods*