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Thread: Would like to hear some opinions on this article re. UTIs...

  1. #1
    Senior Member Timaru's Avatar
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    Would like to hear some opinions on this article re. UTIs...

    So should testing be improved?

    Most GPs diagnose UTIs using standard urine culture and dipstick test diagnostics, but while cheap, these have been continuously criticised in the scientific literature for being too insensitive. ?Studies in the US which tested these culture techniques misdiagnosed about 50% of acute cystitis cases,? Malone-Lee says. ?In our clinic, we?ve repeated these experiments several times in people with chronic and recurrent UTIs and reached the same result. So you have this inaccuracy in the culture and you add to that the inherent inadequacies of the dipstick test itself.?

    Malone-Lee believes that misdiagnosing patients who have a UTI as being all-clear is a particular problem because acute bladder infections need to be taken more seriously than they are. ?There have been experiments on mice which show that if you hit these infections hard and aggressively at the beginning, you will clear them,? he says. ?But if you don?t do anything, the microbes interact and alter the physiology of the bladder cells so they can invade and set up a chronic recalcitrant infection that is difficult to eradicate.?
    In his clinic, he has found that a far more effective means of diagnosing UTIs has been to return to the original methods of the 1920s, which examined the numbers of white blood cells in the urine sample.?Ironically, the people who diagnose UTIs best are in the developing world because they examine the white cell count under microscopes,? he says. ?It?s the cheapest option and has never been bettered as a diagnostic approach.?

    https://www.theguardian.com/lifeands...e_iOSApp_Other

  2. #2
    My physicians, in 35 years, have never used a dipstick test to diagnose urinary tract infections. My doctors' standard practice has always been to order a urinalysis (UA) and a culture & sensitivity (C&S). The C&S is likely done as an automated process, not someone looking through a microscope counting white blood cells. Once the C&S identifies the the bacteria and the most effective antibiotic, the doctor prescribes a 10, but usually 14 day course. Then 2-3 days after the antibiotics are finished, I have an order to get another UA and C&S. These tests make sure that the urine is sterile and the bacteria has been eliminated.

  3. #3
    I would agree with gj. The standard of care for our patients and even in our community is what is stated in his post: Urine C&S and a UA. Follow up cultures are important especially in those who have a history of uti's -

    In all my years of practice, I have never dipsticked a urine for an infection. I am not sure that I would agree with the authors on a lot of their points - but it is interesting to see what others may bee doing.

    ckf

  4. #4
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    I’m surprised at their finding that there is little evidence that drinking water helps much claiming you’re not going to wash the bacteria out but drinking water can dilute the urine. Thus affecting diagnostic tests that typically come back negative, making it appear that the patient has been cured.

    The labs here use only do C&S if the UA shows an infection. Seems like a problem with this policy if drinking liters of water can cause a false negative diagnosis on the UA.

  5. #5
    Senior Member Timaru's Avatar
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    The article is from a UK newspaper.

    Our GPs and district nurses usually dip the urine sample and if it tests positive send it off to the lab.

    I've had several all clears come back from the lab after a course of antibiotics when I was damn sure I was still infected, I was wondering if this could be caused by dilution as the article suggests.

  6. #6
    It definitely could be caused by the dilution. I have had my physician tell me that when I thought that I had a uti. You should hydrate well - but not over hydrate. By that I mean that your urine should have a little color to it and depending on what you normally drink, that plus maybe a little more before going to have a dipstick done should do the trick.
    ckf

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