Urine Reagent Research Articles

Infections urinaires nosocomiales : qui traiter, quand traiter et comment traiter en gériatrie ?

Geriatric patient with nosocomial urinary tract infection (NUTI) frequently display an atypical clinical presentation. The diagnosis may be difficult because of the prevalence of asymptomatic bacteriuria among the elderly. Pyuria is not an accurate predictor of bacteriuria. Using a urinary reagent strip is far more useful in ruling out than in predicting NUTI. The diagnosis of NUTI is often a diagnosis of exclusion. A European study of febrile patients concluded that in only 10% of the cases, fever could be attributable to NUTI. Most institution considered counts > 10 4 CFU mL –1 as clinically significant, and for catheter associated UTI > 10 3 CFU mL –1. Sampling urine culture should be performed before choosing an antimicrobial therapy for UTI. Empiric management should be a 10 days systemic fluoroquinolone course for female patients, 14 to 28 days for male patients. Despite a high prevalence of NUTIs and particularly asymptomatic bacteriuria, numerous questions remain to be answered regarding their diagnosis and management.

Outils du diagnostic biologique des infections urinaires nosocomiales (IUN) : analyse critique

Nosocomial urinary tract infections (NUTI) are the most frequent nosocomial infections. They are often associated with vesical catheterization. The current criteria of definition are based on the presence of symptoms, of vesical catheterization, and on the level of pyuria and bacteriuria determined by urinalysis. These definitions do not take into account all situations and must be reviewed. The conditions of sampling, transfer to the laboratory, and conservation of urines greatly influence the level of pyuria and the level and nature of bacteriuria. The interpretation of the urinalysis must take into account various clinical and epidemiological situations. Patients harboring an urinary catheter are often asymptomatic; they present a nonspecific pyuria all the more frequent that the duration of catheterization is long. Among these patients, the diagnosis of NUTI is based primarily on the level of the bacteriuria which is generally polymicrobial and always present after long-term catheterization. The absence of pyuria is a good negative predictor for non-catheterized symptomatic patients. Pyuria associated with bacteriuria, even low (10 3 to 10 5 cfu mL –1), proves the presence of UTI in these patients. Screening by urinary reagent strips cannot replace urinalysis for either symptomatic or catheterized patients. The systematic screening of UTI (using either a urinary reagent strips or urinalysis) is justified only when treatment is required in case of positive results.

Les infections urinaires nosocomiales en gériatrie : revue de la littérature

The most frequent nosocomial infection in geriatric patients is urinary tract infection (UTI, 30 to 50%). The main risk factors are: age, long-term catheterization, and restricted mobility. There is no specific bacteriologic criteria for elderly patients. Urinary symptoms are often absent, but other clinical symptoms are present. Asymptomatic bacteriuria does not require antibiotherapy. The urinary reagent strip is a reliable screening test. Short-term therapy for UTIs seems to be efficient in elderly female patients. The main prevention consists in applying standard hygiene procedures.

Infections urinaires nosocomiales en réanimation

The purpose of this review was to analyze literature concerning the diagnostic, prevention, and management of nosocomial urinary tract infection (NUTI) in intensive care unit (ICU) patients harboring a urinary catheter. Analysis was performed from personal and “Pubmed” data, using the following keywords: “urinary tract infection” and “intensive care unit”. A lot of expert advice and reviews were found but few clinical trials concerning ICU patients. There was no consensus of the use of urinary reagent tests for the diagnosis. Its usefulness was recommended by one study defining bacteriuria as the presence of 10 5 bacteria mL –1. The prevention of UTI in ICU was not extensively assessed. One prospective, non randomized study showed the uselessness of complex close drainage systems to prevent bacteriuria. One prospective and randomized study proved the lack of effectiveness of silver-coated urinary catheters, compared to standard catheters. Bladder irrigation was responsible for an increase in multiresistant bacteria. Antimicrobial treatment should not be administrated in prophylaxis. The management of catheter-associated UTIS in ICU patients has not been evaluated in clinical trials. Only one study suggested a systemic treatment in patients with candiduria. The level of evidence given by this data is weak and shows the need to make randomized studies in the field of catheter-associated UTIS in ICU patients.

Infections nosocomiales en chirurgie

The aim of this study was to review data on nosocomial infection in surgical wards, especially in urological surgery wards. There is no specific definition for nosocomial infection in surgical wards. Diagnostic criteria are based on Atlanta CDC definitions and in France, on the French Superior Committee on Hygiene. These criterias are clinical and/or microbiological. The urinary reagent strip has a poor predictive value for the diagnosis of postoperative urinary infection, because of frequent hematuria. Recommendations concerning systematic bacteriologic urine analysis only concern the preoperative time. There is no consensus for the management of asymptomatic postoperative bacteriuria. Many studies have been made to evaluate the infectious risk in transurethral resection of the prostate (Turp). They conclude that only patients with sterile urine should be operated on. The micro-organic source of urine contamination is still discussed. Antibioprophylaxis was proved efficient for Turp, but a more conservative use is now suggested.

Cerebrospinal Fluid Analysis with Urinary Reagent Strips

Cerebrospinal Fluid Analysis with Urinary Reagent Strips

A importância dos controles domiciliares na redução de internações em portadores de diabetes mellitus do tipo 1

Vários esquemas terapêuticos, geralmente com base na determinação da glicemia capilar, têm sido utilizados para melhorar o controle do diabetes mellitus do tipo 1 (DM1). Em vista da dificuldade de obtenção de múltiplas amostras sangüíneas diárias, pelo stress da punção e/ou pelo alto custo da determinação glicêmica, freqüentemente utilizamos a glicosúria como um parâmetro da glicemia, Em 1990 criamos um ambulatório específico para os diabéticos em nosso serviço e, desde 1992, com a doação de tiras para determinação domiciliar de glicemia, glicosúria e cetonúria aos pacientes carentes, passamos a cobrar o controle domiciliar. O objetivo do presente trabalho foi avaliar a influência da realização de controles domiciliares rotineiros no número de internações dos pacientes portadores de DM1. Analisamos os números: de pacientes acompanhados (P), de internações (I), de tiras distribuídas anualmente (U= glicosúria/cetonúria, S= glicemia) e a relação I/P. Observamos que apesar do aumento progressivo do número de pacientes acompanhados, houve queda das internações acompanhando o aumento progressivo do material fornecido para controle domiciliar, chegando a ser ó a 8 vezes menor que as observadas em 1989. Houve correlação inversa entre o número de tiras urinárias fornecidas (U/P) e a porcentagem de internações (r= -0,83, p< 0,05). Concluímos que um grupo estruturado para tratamento de DM1 permitiu um melhor controle da doença com diminuição das internações e que apesar de pouco valorizada pela literatura, a determinação de glicosúria é importante no tratamento do DM1 na faixa etária pediátrica.

Does the use of urinary reagent strip tests improve the bedside diagnosis of meningitis?

Does the use of urinary reagent strip tests improve the bedside diagnosis of meningitis?

Comparing Urinary Reagent Strips for Detecting Glycosuria in Patients With Diabetes Mellitus

We evaluated seven types of urinary reagent strips for their reliability and accuracy in detecting glycosuria. We randomly collected 329 urine samples from 253 patients with diabetes mellitus and tested them with each of the reagent strips as well as simultaneously with a laboratory glucose oxidase method. Each reagent strip was effective in detecting glycosuria based on quantitative measurements determined by the laboratory method. The strips were less sensitive in detecting glycosuria in positive semiquantitative ranges. When the plasma glucose level increased to greater than 180 mg/dL, the positive detection rate of glycosuria by all reagent strips increased proportionately. Moreover, two of the strips had a significantly higher ability to detect glycosuria compared with other reagent strips. The variation of renal glucose threshold among patients with diabetes mellitus, however, should be considered when using urinary reagent strips to detect urine glucose.

Usability of Urinary Reagent Strips in Diagnosis of Meningitis

Usability of Urinary Reagent Strips in Diagnosis of Meningitis

The People's Book of Medical Tests

We are entering a period of greater involvement by individuals in their own health care. People want to know more about medicine, so that they can make intelligent choices among the many options that are available to them. Here is a book to help individuals learn more about medical tests— blood and urine tests, tests for infection, tests for heart disease, tests for women, tests for men, x-rays, nuclear scans, ultrasound, scoping procedures, biopsies and taps, miscellaneous tests, and home tests.<i>The People's Book of Medical Tests</i>covers several hundred different tests. A nice feature of this book is information on the cost of each test, which is given as a range. The table on the composition of urinary reagent strip tests and their relative costs is one of the best I have seen. The discussion of home or self tests is particularly good. Most physicians, as well as laypersons,