Flores-Alfaro E, Parra-Rojas I, Jiménez-Acevedo A, Fernández-Tilapa G

Language: Spanish
References: 23
Page: 376-380
PDF size: 115.81 Kb.

ABSTRACT

Objective. To determine the validity of the presumptive tests used to analyze urine in order to detect urinary tract infections in patients with diabetes mellitus type-2. Material and Methods. In 2001, a cross-sectional study was carried out in 160 patients with diabetes mellitus type-2 who were clinically diagnosed with urinary tract infections. Patients were from Tlapa, which is located in the state of Guerrero. Urine samples were microscopically analyzed to determine the number of leukocytes and bacteria in centrifuged samples and urine without centrifuge. The leukocyte esterasa and nitrites were measured using reactive strips. All samples were subjected to urine culture to confirm urinary tract infections. Sensitivity, specificity, and predictive values were calculated for leukocyte count, bacteriuria, leukocyte esterasa and nitrites using positive urine cultures as the standard of measurement. Results. Urinary tract infections were confirmed in 31% of patients. The presence of bacteria in centrifuged urine, leukocyte esterasa and the leukocyte count were all high with respect to sensitivity and specificity. Conclusions. Leukocyte esterasa and microscopic bacteriuria measurements in centrifuged urine offer reliability in the early diagnosis of urinary tract infections.

REFERENCES

1. Naber KG, Bergman B, Bishop MC, Bjerklund-Johanuen TE, Botto H, Lobel B et al. EAU guidelines for the management of urinary and male genital tract infections. Urinary Tract Infection (UTI) Working Group of the Health Care Office (HCO) of the European Association of Urology (EAU). Eur Urol 2001;40(5):576-588.

2. Nicolle LE. A practical guide to antimicrobial management of complicates urinary tract infection. Drugs Aging 2001;18(4):243-254. 3. Wullt B, Bergsten G, Fisher H. Application of laboratory research in UTI. EAU Update Series 2(2004):116-124.

3. Cabezas-Agrícola JM, Touriño Perlaba R, Cabezas-Cerrato J. Complicaciones crónicas de la diabetes mellitus. Medicine 2004;9(16):990-999.

4. Boyko EJ, Fihn SD, Scholes D, Chen CL, Normand EH, Yarbro P. Diabetes and the risk of acute urinary tract infection among postmenopausal women. Diabetes Care 2002;25:1778-1783.

5. Ronald A, Ludwig E. Urinary tract infections in adults with diabetes. Int J Antimicrob Agents 2001;17(4):287-292.

6. Stapleton A. Urinary tract infections in patients with diabetes. Am J Med 2002;113 Suppl 1A:80S-84S.

7. Hernández-Mijares A, Morillas-Ariño C, Lluch-Verdú I, Riera-Fortuny C, Graña-Fandos J, Iñigo-Zaera P et al. Infección y diabetes. Semergen 2000;24 (7):539-544.

8. Olaiz G, Rojas R, Barquera S, Shamah T, Aguilar C, Cravioto P et al. Encuesta Nacional de Salud 2000. La salud de los adultos. Cuernavaca, Morelos, México; Instituto Nacional de Salud Pública, 2003;52:94-103.

9. Secretaría de Salud. Principales causas de mortalidad general 2003. México DF, SSA, 2005. Disponible en: http://www.salud.gob.mx.

10. Goswami R, Bal CS, Tejaswi S, Punjabi GV, Kapil A, Kochupillai N. Prevalence of urinary tract infection and renal scars in patients with diabetes mellitus. Diabetes Res Clin Pract 2001;53(3):181-186.

11. Geerlings SE, Stolk RP, Camps MJ, Netten PM, Hoekstra JB, Bouter KP et al. Asymptomatic bacteriuria may be considered a complication in women with diabetes. Diabetes Mellitus Women Asymptomatic Bacteriuria Utrecht Study Group. Diabetes Care 2000;23(6):744-749.

12. Kehinde EO, Rotimi VO, Al-Awadi KA, Abdul-Halim H, Boland F, Al-Hunayan A et al. Factors predisposing to urinary tract infection after ureteral stent insertion. J Urol 2002;167(3):1334-1337.

13. Aguirre-Avalos G, Zavala-Silva ML, Diaz-Nava A, Amaya-Tapia G, Aguilar-Benavides S. Asymtomatic bacteriuria and inflammatory response to urinary tract infection of elderly ambulatory women in nursing homes. Arch Med Res 1999;30(1):29-32.

14. Laso MC. Interpretación del análisis de orina. Arch Argent Pediatr 2002;100(2):179-183.

15. Lumbiganon P, Chongsomchai C, Chumworathayee B, Thinkhamrop J. Reagent strip testing is not sensitive for the screening of asyntomatic bacteriuria in pregnant women. J Med Assoc Thai 2002;85(8):922-927.

16. Tincello DG, Richmond DH. Evaluation of reagent strips in detecting asymptomatic bacteriuria in early pregnancy: Prospective case series. BMJ 1998;316(7129):435-437.

17. Uncu Y, Uncu G, Esmer A, Bilgel N. Should asymptomatic bacteriuria be screened in pregnancy? Clin Exp Obstet Gynecol 2002;29(4):281-285.

18. Nunns D, Smith AR, Hosker G. Reagent strip testing urine for significant bacteriuria in a udorynamic clinic. Br J Urol 1995;76(1):87-89.

19. Etherington IJ, James DK. Reagent strip testing of antenatal urine specimens for infection. Br J Obstet Gynaecol 1993;100(9):806-808.

20. Leanos-Miranda A, Contreras-Hernández I, Camacho R, Villagómez-Salcedo E, Cervantes-Gorayeb I. Diagnóstico de infecciones del tracto urinario por varias pruebas urinarias. Rev Invest Clin 1996;48(2):117-123.

21. Shaw KN, McGowan KL, Gorelick MH, Schwartz JS. Screening for urinary tract infection in infants in the emergency department: Which test is best? Pediatrics 1998;101(6):150-157.

22. Brauner A, Flodin U, Hylander B, Ostenson CG. Bacteriuria, bacterial virulence and host factors in diabetic patients. Diabet Med 1993;10(6):550-554.

23. American Academy of Pediatrics. Committee on Quality Improvement. Practice parameter: The diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. Pediatrics 1999;103:843-852.