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Evaluation of DipStreak containing CNA-MacConkey agar: a new bedside urine culture device.

BACKGROUND
Many bedside urine culture devices have been developed with the aim of reliability, simplicity and use in both the physician's office and the clinical laboratory.


OBJECTIVE
To compare a novel bedside urine culture device (DipStreak, Novamed Ltd., Israel) comprising a combination of MacConkey and Columbia CNA blood agar with conventional seeding on the same culture media.


METHODS
A total of 1,000 urine specimens sent to our microbiology laboratory were simultaneously processed by both methods. Results were evaluated after 24 and 48 hours incubation at 37 degrees C.


RESULTS
Altogether, 171 (17.1%) and 124 (12.4%) specimens were defined as positive by the conventional method using cutoff values of 10(4) colony-forming units/ml and 10(5) CFU/ml respectively; 178 specimens (17.8%) were defined as contaminated. The sensitivity, specificity, positive and negative predictive values of DipStreak for urinary tract infection were 98.8%, 98.6%, 96% and 99.6% respectively, using a cutoff value of 10(4) CFU/ml, and 99.3%, 99.2%, 96% and 99.8% respectively, using cutoff value of 10(5) CFU/ml. Full agreement between both techniques was 95%.


CONCLUSIONS
The agreement rate between DipStreak and conventional seeding was remarkably high. These results suggest that DipStreak in the agar combination tested in this study is a useful and precise tool for diagnosing urinary tract infections.