Role of automated urine analyser in the diagnosis of urinary tract infection.

ABSTRACT

Aim: Although urine culture is used as the reference standard to determine presence or absence of urinary tract infection (UTI), culture is an expensive and time-consuming method. The objectives of the study were to compare automated dipstick urinalysis with microscopic urinalysis and form an algorithm to reduce time and labour of the pathologist and faster initiation of treatment to the patient. Method: 500 morning urine samples were analysed by using automated dipstick analyser( Cobas u 411) and those samples showing abnormal results were subjected to microscopy. Leucocyte esterase and nitrite positivity were taken into consideration as predictive indicators of UTI. Result: 34% of the samples showed abnormal results on automated urine analyser. Total 28% samples showed positive results for leucocytes, nitrite, protein and RBC’s were sent for urine culture. 5% samples grossly turbid were sent for culture. Conclusion: Automated urinalysis method can be used for the rapid diagnosis of UTI. The algorithm presented in this study will guide the pathologist to decide when culture should be advised after urinalysis. Urine culture is an expensive test for routine use and should not be applied unless the result of nitrite, leukocyte or RBC’s are positive on automated dipstick/ microscopic examination.