Screening for Bacteriuria in Urological Patients using Reagent Strips

Summary— A rapid and accurate ward‐based method of diagnosing urinary infection would be of value in determining the prescription of antibiotics in pre‐operative urological patients. This study describes the sensitivity and specificity of a screening technique based on commercially available reagent strips in the diagnosis of urinary infection. A total of 222 pre‐operative samples and 83 post‐operative samples was studied to compare the results of formal urine culture and reagent strips. Using a definition of a positive nitrite or a positive leucocyte esterase on the reagent strips as being suggestive of infection, it was found that the strips had a sensitivity of 91% and a specificity of 85% compared with formal culture in pre‐operative samples. The results from post‐operative samples were less satisfactory, the strips having a sensitivity of only 71% and specificity of 55%. The strips were insensitive but specific in the identification of pyuria in pre‐operative specimens. These results suggest that reagent strips can be used as a ward‐based method to identify men at risk of infection before urological procedures, and may allow selectivity in the use of peri‐operative antibiotics.