title: Diagnostic accuracy of uriSed automated urine microscopic sediment analyzer and dipstick parameters in predicting urine culture test results.
abstract: BACKGROUND
  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 positive urine cultures.
  
  
  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 semiquantitative urine culture.
  
  
  RESULTS
  Of 384 urinary specimens, 68 were positive for bacteriuria by culture, and were thus considered true positives. Comparison of these results with those obtained from the UriSed analyzer indicated 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% CI = 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 reliable clinical test.
  
  
  CONCLUSIONS
  Although the specificity of the UriSed analyzer was within acceptable limits, the sensitivity value was low. Thus, UriSed urinalysis resuIts do not accurately predict the outcome of culture.
authors.affiliation: Department of Clinical Laboratory, Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey.
authors.forename: Kağan
authors.initials: K
authors.lastname: Huysal
authors.forename: Yasemin U
authors.initials: YU
authors.lastname: Budak
authors.forename: Ayse Ulusoy
authors.initials: AU
authors.lastname: Karaca
authors.forename: Murat
authors.initials: M
authors.lastname: Aydos
authors.forename: Serdar
authors.initials: S
authors.lastname: Kahvecioğlu
authors.forename: Mehtap
authors.initials: M
authors.lastname: Bulut
authors.forename: Murat
authors.initials: M
authors.lastname: Polat
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001331:Automation; D001437:Bacteriuria / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D016482:Urinalysis; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000382:microbiology; D055815:Young Adult
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