Nitrite and leukocyte dipstick testing for urinary tract infection in individuals with spinal cord injury

Jeanne M. Hoffman, Rohini Wadhwani, Eve Kelly, Bonnie Dixit, Diana D. Cardenas

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Objective: To determine sensitivity, specificity, and positive and negative predictive values of nitrite (NIT) and leukocyte esterase (LE) testing in relation to laboratory evidence of significant bacteriuria and urinary tract infection (UTI) in persons with spinal cord injury (SCI). Design: Monthly urine cultures were compared with results of dipstick testing. Setting: Community based. Methods: Fifty-six people with SCI were evaluated on a monthly basis with dipstick testing for NIT and LE as well as urine cultures. Participants reported whether they believed that they had a UTI and, if so, whether they were treated for the UTI and what symptoms they had experienced. Results: The sensitivity rate for the most comprehensive criteria-defined as positive NIT test, a positive LE positive, or both a positive NIT test and positive LE test-was 0.64 and the specificity rate was only 0.52. No single type of bacteria was found to occur in more than 30% of the urine samples. Conclusion: Reliance on dipstick testing for NIT and LE in individuals with SCI can lead to high rates of overtreatment for UTI, given the fact that regular catheterization is associated with significant bacteriuria. Individuals with SCI should be evaluated with urine culture to ensure proper treatment.

Original languageEnglish (US)
Pages (from-to)128-132
Number of pages5
JournalJournal of Spinal Cord Medicine
Volume27
Issue number2
DOIs
StatePublished - Jan 1 2004

Keywords

  • Bacteriuria
  • Leukocyte esterase
  • Nitrites
  • Spinal cord injuries
  • Urinary tract infection
  • Urine culture

ASJC Scopus subject areas

  • Clinical Neurology

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