الفهرس 
Urinary Tract InfectionOnly 14 pages are availabe for public view
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Abstract
U
rinary tract infection is the second most common infection diagnosed in the acute hospital setting and accounts for almost 5% of all emergency department visits by adults aged 65 years and older.
Most urinary tract infections are monomicrobial; the most common pathogen is Escherichia coli (70% to 95%) followed by Staphylococcus saprophyticus (5% to 15%). Other less common pathogens include species of Enterobacteriaceae such as Klebsiella pneumoniae and Proteus mirabilis, Enterococcus faecalis, GBS, and Staphylococcus aureus.
The present study aimed to evaluate the use of MMB test as a rapid screening method for significant bacteriuria with resources that are easily affordable and commercially available.
The study included one thousand urine samples collected from patients clinically suspected of UTI attending Ain Shams University Hospitals (inpatient ward and outpatient clinic). Each sample was subjected to semiquantitative urine culture, urine analysis and MMB test.
One hundred urine samples were collected from apparently healthy individuals as a control.
The results of this study revealed that a total of 145/189 (62.5%) had significant bacterial growth of ≥105 CFU/ml and 44/189 (4.4%) had non-significant growth (104-105), while 811/1000 (81.1%) were negative cultures and had no bacterial growth.
E.coli was the most common microorganism detected 62/189 (32.8%). Klebsiella Spp. was the second 42/189 (22.2%) while Staphylococcus coagulase negative was the third 27/189 (14.3%).
Analysis of data of urine analysis revealed that each of pH, ketones, glucose, urobilinogen and epithelial cells in urine has no significant statistical association with either MMB test or culture results (P < 0.05).
On the other hand, presence of: Albumin, nitrate, leucocyte-esterase, blood, pus cells, RBCs, amorphous & crystals in urine show significant statistical association with both MMB test or culture results (P > 0.05).
The results of casts & bilirubin, together with the color of urine show significant statistical association with MMB test only while no significant statistical association with culture results.
All control samples that collected from apparently healthy individuals show negative culture results and negative MMB test for significant bacteriuria (<105 CFU/ml).
The results of MMB test for screening of bacteriuria was compared to those of conventional urine culture as the standard method, the MMB test found to have 89.3% specificity, 76.7% sensitivity, positive predictive value of 62.5% and negative predictive value of 94.3%.
Modified methylene blue test is a rapid screening test for UTI but it can only detect bacteriuria with colony count ≥105 CFU/ml.