Abstract：
OBJECTIVES:We wanted to assess the diagnostic accuracy of urinary dipstick testing in excluding catheter-associated urinary tract infection (CAUTI) in intensive care unit (ICU) patients with fever or hypothermia. METHODS:This was a prospective observational cohort study in a medical-surgical ICU. Patients with new-onset fever >38.3 °C or hypothermia <36 °C at least 48 h after urinary catheter insertion were included over a 2-year period. At each episode, a urinary dipstick test and a urine culture were performed as the criterion standard. Extensive microbiological investigations for extra-urinary infections were performed also. The performances of various urinary dipstick result combinations in ruling out CAUTI were compared based on the likelihood ratios (LR+ and LR-). RESULTS:Symptomatic CAUTI was diagnosed in 31 (24.4 %) of the 127 included patients (195 episodes of fever or hypothermia). LR+ was best for combined leukocyte esterase-positive and nitrite-positive dipstick results (overall population: 14.91; 95 % confidence interval [95 % CI], 5.53-40.19; patients without urinary symptoms: 15.63; 95 % CI, 5.76-42.39). LR- was best for either leukocyte esterase-positive or nitrite-positive dipstick results (overall population: 0.41; 95 % CI, 0.57-0.65; patients without urinary symptoms, 0.36; 95 % CI, 0.21-0.60). CONCLUSIONS:Urinary dipstick testing at the bedside does not help to rule out symptomatic CAUTI in medical or surgical ICU patients with fever or hypothermia.
journal_name
Infectionjournal_title
Infectionauthors
Coman T,Troché G,Semoun O,Pangon B,Mignon F,Jacq G,Merceron S,Abbosh N,Laurent V,Guezennec P,Henry-Lagarrigue M,Revault-d'Allonnes L,Ben-Mokhtar H,Audibert J,Bruneel F,Resche-Rigon M,Bedos JP,Legriel Sdoi
10.1007/s15010-014-0612-6subject
Has Abstractpub_date
2014-08-01 00:00:00pages
661-8issue
4eissn
0300-8126issn
1439-0973journal_volume
42pub_type
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