Tests
Your Organizational Guidance
ebpracticenet urges you to prioritize the following organizational guidance:
Cystitis bij de vrouwPublished by: Werkgroep Ontwikkeling Richtlijnen Eerste Lijn (Worel)Last published: 2017La cystite chez la femmePublished by: Groupe de Travail Développement de recommmandations de première ligneLast published: 20171st tests to order
urinalysis
Test
Performed on clean catch midstream dipstick specimen.
Indicated if diagnosis is uncertain, or if complicating features are present.[37]
The presence of hematuria combined with a positive dipstick test for nitrites has a high diagnostic utility for ruling in the diagnosis of urinary tract infection.[33] Do not define microhematuria by positive dipstick testing alone. Only define microhematuria using urine microscopy.[35][36]
Result
positive for leukocyte esterase, nitrites, and hemoglobin
urine microscopy
Test
Performed on clean catch midstream dipstick specimen.
Greater than 10 WBC per high-powered field of an unspun urine is considered diagnostic.
Microscopic detection of red blood cells instead of hemoglobin excludes false-positive urinalysis results from myoglobin or hemoglobin. Only define microhematuria using urine microscopy: three or more red blood cells per high-powered field on microscopy of a properly collected urinary specimen.[35][36] Radiographic and cystoscopic evaluation is unnecessary in the absence of microscopically confirmed microhematuria.[35]
Epithelial cells suggest a contaminated specimen.
Result
presence of red blood cells, white blood cells, and bacteria
urine culture with sensitivity
Test
Performed on clean catch midstream dipstick specimen.[38]
Greater than 10³ colony-forming units/mL of urine is the gold standard of diagnosis. Many laboratories use the cutoff of only 10⁴ colony-forming units/mL of urine. For a suprapubic aspirate, the cutoff of only 10² colony-forming units/mL of urine should be applied.[39]
Most specific and sensitive. Positive urine culture identifies infecting organism. Enables modification of treatment based on antibiotic susceptibility.[38]
Result
identification of infecting organism
Tests to consider
pregnancy test
Test
Screened before treatment if applicable.
Result
positive
Use of this content is subject to our disclaimer