title: Utility of dipstick urinalysis in peri- and postmenopausal women with irritative bladder symptoms.
abstract: OBJECTIVE
  Previous studies of dipstick urinalysis (UA) in asymptomatic peri- and postmenopausal women demonstrate poor sensitivity to detect a urinary tract infection (UTI). We hypothesized that sensitivity of this test would be improved in symptomatic peri- and postmenopausal women.
  
  
  METHODS
  This was a cross-sectional study of 76 women seeking urogynecology care for irritative bladder symptoms. Subjects with a positive clean-catch (CC) dipstick UA for leukocyte esterase (LE) or nitrites (NIT) were offered enrollment. Dipstick UA was performed on CC and catheterized specimens, followed by microbiologic culture. Test characteristics were calculated for CC and catheterized UA. CC culture was compared with catheterized culture (gold standard) using Spearman's correlation coefficient.
  
  
  RESULTS
  Data was available for analysis in 75/76 (98.7 %) enrolled subjects. Mean age was 68 ± 11 years. Most subjects were postmenopausal (98.7 %) and Caucasian (97.3 %). Dipstick sensitivity ranged from 48 % to 87 % and 35 % to 57 % in CC and catheterized specimens, respectively. Dipstick UA from a CC specimen positive for NIT had the highest sensitivity (60.9), specificity (100), negative predictive value (85.2), and positive predictive value (100) in this population. Dipstick UA from CC and catheterized specimens had similar sensitivity for detecting UTIs. When culture results of 10(3) colony-forming units were considered positive, CC and catheterized specimens were moderately correlated (ρ = 0.470).
  
  
  CONCLUSIONS
  Dipstick UA in this study had improved sensitivity compared with previously published results in both CC and catheterized samples. Initiation of empiric antibiotic treatment in women with irritative bladder symptoms and NIT-positive CC dipstick UA prior to obtaining urine culture results is a reasonable option.
authors.affiliation: Division of Urogynecology, Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh-School of Medicine, 300 Halket Street, Pittsburgh, PA, 15213, USA.
authors.forename: Lindsay C
authors.initials: LC
authors.lastname: Turner
authors.forename: Richard
authors.initials: R
authors.lastname: Beigi
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Shepherd
authors.forename: Jerry L
authors.initials: JL
authors.lastname: Lowder
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D047648:Perimenopause; D017698:Postmenopause; D011934:Reagent Strips; D012680:Sensitivity and Specificity; D016482:Urinalysis / Q000379:methods*; D014546:Urinary Catheterization; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000652:urine; D059349:Urine Specimen Collection
chemical_list: D011934:Reagent Strips