Submit Manuscript | http://medcraveonline.com Introduction Urinalysis and urine culture are the commonest tests ordered by clinicians. These tests account for almost 60-70% of the workload of any clinical microbiology lab. Some large labs get as much as 200- 300 urine samples per day. Given that majority of them (around 80%) would eventually show no growth on culture, there is huge interest in ways to screen out these negative samples. Empiric treatment of urinary tract infection is one of the commonest causes of inappropriate and unnecessary antibiotic usage. 1 In judicious antibiotic usage is most common factor leading to multi drug resistant organisms almost 20% of laboratory samples have antibiotic resistance. 2,3 Dipstick provide a less time consuming and inexpensive alternative and is most commonly used for near patient/point of care testing by clinicians in primary care 4–7 Reliable screening tests/near patients tests (NPTs)/ point of care tests for diagnosis of UTI would facilitate early diagnosis and treatment and if negative would help avoid unnecessary, expensive time consuming culture. Of late, there has been a lot of interest in the urine screening tests and these have been a topic of research in recent times. Many studies have been done on the comparison of various dipstick parameters (widely used as screening tests) with bacterial culture. The reports however, have been conficting. The present study was undertaken to evaluate the utility of various parameters assessed by use of urinary dipsticks in predicting urinary tract infections. Materials and methods An observational study was carried out in Department of Microbiology of a tertiary care hospital between May to August 2012 to evaluate the effcacy of urinary dipsticks in predicting UTI. A total of 667 urine samples were analysed. The sample size calculation was done by taking into account the total number of urine samples received (20000 samples/year) Using the data for sensitivity and specifcity (-70%) available from literature and assuming the type 1 error to be 0.5% Multistix 10 SG(Seimens) reagent strips were used in the study. Calibrated loops were used to culture 1mL of urine on to MacConkey and Sheep Blood agar plates (Biomerieux). The criterion for clinically signifcant bacteriuria was a pure/predominant culture of 10^5 cfu/ml of the microorganism. The nitrite test depends upon the presence of nitrites in urine. The bacteria in urine produce an enzyme nitrate reductase which reduces nitrate to nitrite. So if bacteria are present in urine the nitrite test will be positive. The leukocyte esterase test uses derivatized pyrrole amino acid ester to diagnose leukocyte esterase in WBCs. Comparison of leukocyte esterase, nitrite and presence of proteins in urine with culture was done. Sensitivity, specifcity, positive predictive value and negative predictive values of each of these markers was calculated. Table 1 Sensitivity (in comparison to gold standard i.e. culture) Leukocyte Esterase 51.2 Nitrite 37.8 Proteinuria 44.1 Leukocyte Esterase+Nitrite 62.2 Leukocyte Esterase+Proteinuria 67.7 Nitrite+Proteinuria 64.6 Leukocyte Esterase+Nitrite+Proteinuria 74 J Bacteriol Mycol Open Access. 2016;2(1):24‒26. 24 ©2016 Bagga et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Urinary dipsticks: effcacy as predictor of urinary tract infections Volume 2 Issue 1 - 2016 Ruchika Bagga, Alka Girotra Department of Microbiology, Fortis Healthcare, India Correspondence: Ruchika Bagga, Department of Microbiology, Fortis Healthcare, Gurgaon, Haryana, India, Email ruchikaa.bagga@gmail.com Received: January 19, 2015 | Published: March 30, 2016 Abstract Urinalysis and culture are the two most common investigations performed in a microbiology laboratory. Commercial Dipsticks which detect proteins and various enzymes may offer a rapid and inexpensive alternative to urinalysis and culture. An evaluation of the utility of urinary dipsticks (Multistix 10 SG) in predicting urinary tract infections (UTI) was undertaken. A total of 667 urine samples were evaluated from May to August 2012. Sensitivity, specificity, negative and positive predictive values were evaluated. The sensitivity for predicting UTI was low: 62% for leukocyte esterase and nitrite; 67% for leukocyte esterase and proteinuria while it was 74% for leukocyte esterase, nitrite and proteinuria, all three together. However, the negative predictive value (NPV) for UTI was better. NPV for UTI with leukocyte esterase and nitrite was 90.3%; for leukocyte esterase and proteinuria was 90.6% while it was 91.5 % for leukocyte esterase, nitrite and proteinuria together. The positive predictive value was very low. Urinary dipsticks therefore appear to be better tools for excluding UTIs and not for diagnosing UTI. Keywords: urinalysis, urine culture, urinary tract infections, urinary dipsticks Journal of Bacteriology & Mycology: Open Access Research Article Open Access