Diagnostic value of different urine tests for urinary tract infection: a systematic review and meta-analysis |
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Authors: | Rong Xie Xinli Li Guangquan Li Rong Fu |
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Affiliation: | 1.Department of Laboratory Medicine, Affiliated Hospital of Chengdu University, Chengdu, China;2.Department of Laboratory Medicine, 363 Hospital, Chengdu, China;3.Department of Laboratory Medicine, Chengdu Second People’s Hospital, Chengdu, China |
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Abstract: | BackgroundThere are differences in specificity and sensitivity of different routine urine tests for urinary tract infection, so meta-analysis was used to compare the diagnostic value of various urine analysis and detection methods in urinary tract infection, including bacterial culture, urine sediment microscopy, automated urinalysis, and routine urine dry chemical methods.MethodsThe PubMed, Embase, Cochrane Library, SpringerLink, CNKI, and Wanfang databases were searched from inception to December 2021. Two system assessors independently screened the literature according to the inclusion and exclusion criteria. RevMan version 5.3 (the Cochrane Collaboration) and Meta-DiSc were used to calculate the combined sensitivity (Sen), specificity (Spe), positive likelihood ratio (LR+), negative likelihood ratio (LR–), and diagnostic ratio (DOR) of the diagnostic tests and draw summary receiver operating characteristic (SROC) curves.ResultsA total of 14 documents were included according to the inclusion and exclusion criteria. There was a significant statistical difference between the urine sediment microscopy group and the urine normalization group in urine leucocyte detection (OR =2.15, 95% CI: 1.29–3.56, P=0.003, I2=19%, Z=2.95), urine erythrocyte test (OR =1.87, 95% CI: 1.13–3.09, P=0.01, I2=0%, Z=2.45), quantitative determination of urinary protein composition (OR =2.32, 95% CI: 1.27–4.23, P=0.006, I2=30%, Z=2.73), and determination of urinary enzymes (OR =1.67, 95% CI: 1.03–2.72, P=0.04, I2=0%, Z=2.07).DiscussionWhen examining red and white blood cells in urinary tract infection diagnosis, urine dry chemistry is superior to automated urinalysis in terms of area under the curve (AUC), Sen, Spe, etc. When examining urine bacteria, urine dry chemistry can be recommended for urine bacteria screening, with bacterial culture required for confirmation. |
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Keywords: | Multiple urine tests urinary tract infection systematic review meta-analysis retrospective study |
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