Screening tests include urine microscopy, gram stain, leukocyte esterase and nitrite tests.
Urine microscopy:Pyuria is defined as >5 WBCs/hpf in centrifuged and >10 WBCs/cu mm in uncentrifuged urine specimen. It may be absent in 30-40% cases of UTI. No. Of WBCs doesn’t correlate with severity of the UTI.
Gram stain for bacteria: Should be performed in uncentrifuged urine. Presence of bacteria carries high likelihood of UTI.
Leukocyte esterase and nitrite tests:These are performed by dipstick on a fresh urine specimen. The likelihood of UTI is high when both or either of these tests is positive. UTI is quiet unlikely if both of these tests are negative.
Urine culture remains the gold standard for the diagnosis of UTI.
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