Salud Pública de México (Oct 2005)
Pruebas presuntivas del análisis de orina en el diagnóstico de infección en vías urinarias entre diabéticos tipo 2 Presuntive tests in screening for detecting urinary tract infections in patients with diabetes type-2
Abstract
OBJETIVO: Determinar la confiabilidad de las pruebas presuntivas del análisis de orina en el diagnóstico temprano de infecciones de vías urinarias entre pacientes con diabetes tipo 2. MATERIAL Y MÉTODOS: En el año 2001 se realizó un estudio transversal entre 160 diabéticos con diagnóstico clínico de infección en vías urinarias, de la ciudad de Tlapa, Guerrero. Se confirmó este diagnóstico por urocultivo, se comparó con las pruebas presuntivas de esterasa leucocitaria, nitritos, cuenta de leucocitos y bacteriuria en orina centrifugada y sin centrifugar. Se calculó la sensibilidad, la especificidad, el valor predictivo positivo y el negativo. RESULTADOS: En 31% de los participantes se confirmó infección urinaria. La presencia de bacterias en orina centrifugada, esterasa leucocitaria y la cuenta de leucocitos presentaron sensibilidad y especificidad altas. CONCLUSIONES: Las mediciones de esterasa leucocitaria y bacteriuria en orina centrifugada ofrecen confiabilidad en el diagnóstico oportuno de infecciones de vías urinarias.OBJECTIVE: To determine the validity of the presumptive tests used to analyze urine in order to detect urinary tract infections in patients with diabetes mellitus type-2. MATERIAL AND METHODS: In 2001, a cross-sectional study was carried out in 160 patients with diabetes mellitus type-2 who were clinically diagnosed with urinary tract infections. Patients were from Tlapa, which is located in the state of Guerrero. Urine samples were microscopically analyzed to determine the number of leukocytes and bacteria in centrifuged samples and urine without centrifuge.The leukocyte esterasa and nitrites were measured using reactive strips. All samples were subjected to urine culture to confirm urinary tract infections. Sensitivity, specificity, and predictive values were calculated for leukocyte count, bacteriuria, leukocyte esterasa and nitrites using positive urine cultures as the standard of measurement. RESULTS: Urinary tract infections were confirmed in 31% of patients. The presence of bacteria in centrifuged urine, leukocyte esterasa and the leukocyte count were all high with respect to sensitivity and specificity. CONCLUSIONS: Leukocyte esterasa and microscopic bacteriuria measurements in centrifuged urine offer reliability in the early diagnosis of urinary tract infections.
