Screening for bacteriuria in patients with spinal cord lesion: dipstick test, microscopic examination and urine culture.

Aim: To investigate the positive and negative predictive values for bacteriuria of a rapid chemical dipstick procedure for leukocytes and nitrite, and a microscopic examination for leukocytes and bacteria with a urine culture being the reference in patients with spinal cord lesion (SCL).
Methods: A prospective study. Significant bacteriuria was defined as > or = 10(5) CFU/mL. The microscopic examination for leukocytes was divided in four different cut-off limits for positive results.
Material: A total of 256 consecutive early morning urine samples were collected from 143 SCL patients admitted to our in-patient facility.
Results: One hundred and twenty-eight urine cultures revealed significant bacteriuria. Eighty-seven were infected by only one microorganism, 41 samples contained significant growth of more than one species. A total of 186 microorganisms in significant growth were identified.
Conclusion: Three or more leukocytes should be considered as a positive result. The dipstick and microscopy tests are equally valuable, considering the single tests as well as the combinations evaluated.