| Sumario: | Objectives: Urinary tract infection (UTI) is a highly prevalent cause of bacterial infection and urologic disease. Asymptomatic bacteriuria is common and presents without pyuria (<10 WBC x106/L). Sieving protocol uses defined clinical details for samples without pyuria to indicated that they must be cultured. This retrospective study was conducted to assess the possibility of implementing a sieving protocol for urinalysis in the Invercargill laboratory to improve diagnostic and antibiotic stewardship. Methods: A total of 236 urines were analysed between 29th June and 6th July, 2022, and of these, 83 samples had <10 WBC x106/L. A variety of collection techniques including voided midstream urine, catheter urine etc. were accepted for this study. Manual urine microscopy was performed on each specimen and all were cultured onto Blood/Chromogenic Orientation Agar. Any significant growth was analysed by a Senior Scientist, recorded and the causative agent identified. Clinical details that would meet the culture criteria were also recorded. Microsoft excel was used for data analysis and other statistical calculations. Results: Of the 83 urine specimens with <10 WBC x106/L, 11% had significant growth. 34% of urines met the culture criteria and, of the 66% that did not, 11% had significant growth. The margin of error for <10 WBC x106/L urine samples that did not meet the culture criteria but had significant growth was ± 5.5% (95% confidence interval) and for total urine specimens received, it was ± 2%. Conclusion: Implementing the sieving protocol for urinalysis in the Invercargill laboratory will improve diagnostic and antibiotic stewardship, be more cost effective, reduce the harm of over interpreting and over reporting urine cultures and generally enhance patient care.
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