Nitrite and Leukocyte Dipstick Testing For Urinary Tract Infection in Individuals With Spinal Cord Injury

Abstract

Objective: Todetermine sensitivity, specificity, and positive and negative predictive values of nitrite (NIT) and leukocyte esterase (LE) testing in relation to Iabaratory 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 weil 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 singletype ofbacteria was found to occur in more than 3 0% of the urine samples.Conclusion: Reliance on dipstick testing for NIT and LEin individuals with SCI can Iead to high rates of overtreatment for UTI, given the fact that regular catheterization is associated with significant bacteriuria. lndividuals with SCI should be evaluated with urine culture to ensure proper treatment.