Learn to interpret dipstick urinalysis and other tests to diagnose urinary tract infections (UTIs). How do we detect bacteria and leukocytes in urine? What else is necessary to diagnose a UTI? How reliable are our diagnostic tests, and what can throw them off? Common problems like urine sample contamination and asymptomatic bacteriuria and leukocyturia make a clinician's job difficult. It's no wonder that misinterpretation of urinalysis and misdiagnosis of urinary tract infections are important drivers of antibiotic misuse worldwide. This video will help you diagnose urinary tract infections and avoid the most common pitfalls in urinalysis.

Lecture summary in PDF:
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If you want to learn how to recognize life-threatening infections like sepsis and CNS infections as early as possible, I highly recommend you take my free online course!

A Clinical Approach to Serious Infections in Adults: What Every Physician Should Know:
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DISCLAIMER: Please, always keep in mind that my videos are intended for educational purposes only. The content of my videos is NOT medical advice. I do not practice medicine over the internet. If you are a patient and have any questions about your health, please talk to your doctor.

CHAPTERS:
00:00 Urine test strips (urine dipsticks)
00:24 Nitrite in urine
02:45 Leukocyte esterase and leukocyturia
04:20 Microscopic examination or urine sediment, hemocytometry
05:16 How to collect a urine sample and avoid contamination
08:13 Signs of sample contamination
09:28 Significant bacteriuria
11:17 Asymptomatic bacteriuria vs. UTI

REFERENCES & RECOMMENDED READING:
1. Advani SD, Polage CR, Fakih MG. Deconstructing the urinalysis: A novel approach to diagnostic and antimicrobial stewardship. Antimicrob Steward Healthc Epidemiol. 2021;1(1):e6.
2. Wilson ML, Gaido L. Laboratory Diagnosis of Urinary Tract Infections in Adult Patients. Clinical Infectious Diseases. 2004 Apr 15;38(8):1150–8.
3. Pallin DJ, Ronan C, Montazeri K, Wai K, Gold A, Parmar S, et al. Urinalysis in acute care of adults: pitfalls in testing and interpreting results. Open Forum Infect Dis. 2014 Mar;1(1):ofu019.
4. Rowe TA, Juthani-Mehta M. Diagnosis and Management of Urinary Tract Infection in Older Adults. Infect Dis Clin North Am. 2014 Mar;28(1):75–89.
5. Lifshitz E, Kramer L. Outpatient urine culture: does collection technique matter? Arch Intern Med. 2000 Sep 11;160(16):2537–40.
6. Johnson JR, Drekonja DM. Bacteriuria/Pyuria of Clinically Undetermined Significance (BPCUS): Common, but Currently Nameless. The American Journal of Medicine. 2017 May 1;130(5):e201–4.
7. McMurdo M. Commentary. Urinary tract infection in old age: over-diagnosed and over-treated. Age and Ageing. 2000 Jul 1;29(4):297–8.

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