2. UroToday Home
  3. Urology News
  4. Infections

Urinalysis Is Predictive for Absence of Urinary Tract Infection in Men with and Without Catheters - Beyond the Abstract

The goal of the study was to determine predictive accuracy of a negative urinalysis for negative urine culture and the absence of urinary tract infection in men both with and without indwelling urinary catheters. Similar to our findings in women (PMID 36898589), when urinalysis was negative (LE, WBC, nitrite) in men, only 5% of urine cultures grew uropathogenic bacteria, and only 1% of negative urinalyses were associated with urinary tract infection.

Similar findings were seen in those who voided and in those who used urinary catheters for bladder drainage. Additionally, in a sub-analysis of urine cultures, it was demonstrated that a lower uropathogen growth cut-off for urine culture positivity, from >100,000k CFU/ml to >10,000 CFU/ml, resulted in capturing an additional 19% of UTIs. The findings support a protocol wherein, in the context of clinical judgement, urine culture is only performed in cases of abnormal urinalysis. Implementation of such a protocol could result in improved outcomes (through less collateral morbidity due to fewer unnecessary empiric antibiotic prescriptions), improved testing and antibiotic stewardship, and reduction in healthcare expenditures.

Written by: Paul Oh,1 Kevin C Lewis,1 Daniel A Shoskes,1 Sandip Vasavada,1 Howard B Goldman,1 Hadley M Wood,1 Daniel D Rhoads,2,3,4 Glenn T Werneburg1

  1. Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
  2. Department of Laboratory Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
  3. Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
  4. Infection Biology Program, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Read the Abstract