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Urinary Tract Infection: Sensitivity and Specificity

Introduction: An uncomplicated, or lower, UTI is also known as cystitis. The principal symptoms are dysuria, frequency, urgency; hematuria can also be present.

Non-diagnostic historical findings (from Br J Gen Pract. 2006 Aug;56(529):606-12. PMID 16882379) include:

history of backache, fever, feeling unwell, abdominal pain, prior duration, daytime or night-time frequency (number of times), renal angle tenderness, lower abdominal tenderness, previous history of UTI.

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Tags: Infection Tag this Diagnosis.

Differential Diagnoses include: Pyelonephritis

Prevalence

Population / CalculatorPrevalence Comments / Study / Link
Women with suspected UTI 62% Br J Gen Pract. 2006 Aug;56(529):606-12. PMID 16882379
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The sensitivity and specificity of findings for Urinary Tract Infection are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Finding SensitivitySpecificity Comments, Study
Urine Culture Edit 95%85%

>10^2 CFU/ml of E coli. Population: symptomatic women.

Study: N Engl J Med 1982 Aug 19;307(8):463-8. PMID 7099208

Specific Findings

Finding SensitivitySpecificity Comments, Study
Dipstick Nitrite Edit 28%91%

Study: Br J Gen Pract. 2006 Aug;56(529):606-12. PMID 16882379

Urine Malodor Edit 24%90%

Study: Br J Gen Pract. 2006 Aug;56(529):606-12. PMID 16882379

Hematuria Edit 23%88%

moderately severe

Study: Br J Gen Pract. 2006 Aug;56(529):606-12. PMID 16882379

Costovertebral Angle Tenderness Edit 21%88%

Study: JAMA. 2002;287:2701-2710. http://jama.ama-assn.org/cgi/content/full/287/20/2701

Bacteriuria Edit 70%85%

i.e. microscopically visible bacteria in urine

(sensitivity depends a lot on the cutoff number of bacteria)

Study: N Engl J Med. 2003 Jul 17;349(3):259-66. PMID 12867610

Sensitive Findings

Finding SensitivitySpecificity Comments, Study
Self-Diagnosis Edit 100%75%

Study: JAMA. 2002;287:2701-2710. http://jama.ama-assn.org/cgi/content/full/287/20/2701

Pyuria Edit 95%71%

i.e. microscopic leukocytes

Study: N Engl J Med. 2003 Jul 17;349(3):259-66. PMID 12867610

Dipstick Leukocyte Esterase Edit 85%53%

Study: Br J Gen Pract. 2006 Aug;56(529):606-12. PMID 16882379

Poorly Diagnostic Findings

Finding SensitivitySpecificity Comments, Study
Dipstick Leukocyte Esterase or Nitrite Edit 75%82%

Study: N Engl J Med. 2003 Jul 17;349(3):259-66. PMID 12867610

Cloudy Urine Edit 46%79%

Study: Br J Gen Pract. 2006 Aug;56(529):606-12. PMID 16882379

Dipstick Nitrite or Dipstick Blood and Leukocyte Esterase Edit 77%70%

Study: Br J Gen Pract. 2006 Aug;56(529):606-12. PMID 16882379

Dipstick Protein Edit 47%69%

Study: Br J Gen Pract. 2006 Aug;56(529):606-12. PMID 16882379

Nocturia Edit 54%64%

moderately severe

(population is women with suspected UTI)

Study: Br J Gen Pract. 2006 Aug;56(529):606-12. PMID 16882379

Dysuria Edit 70%57%

moderately severe

Study: Br J Gen Pract. 2006 Aug;56(529):606-12. PMID 16882379

Dipstick Blood Edit 73%54%

Study: Br J Gen Pract. 2006 Aug;56(529):606-12. PMID 16882379

Urinary Urgency Edit 62%50%

moderately severe

Study: Br J Gen Pract. 2006 Aug;56(529):606-12. PMID 16882379

Flank Pain Edit 55%50%

Study: JAMA. 2002;287:2701-2710. http://jama.ama-assn.org/cgi/content/full/287/20/2701