Diagnostic Comparison Between Reagent Strips, Urinary Sediment and Urine Culture in Urinary Tract Infections: A Cross-sectional Study

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Abstract
This study aimed to compare urine sediment microscopy and reagent strips with urine culture for the diagnosis of urinary tract infections in outpatients in Jaén, Peru, in 2025. The research was comparative with a quantitative approach. A quantitative, comparative, non-experimental, cross-sectional. The sample consisted of 250 patients over 18 years of age of both genders, evaluated between March and May 2025. Three brands of reagent strips were used (Medi Test combi, ComboStik, and Mission), prioritizing the detection of nitrites and leukocyte esterase. Microscopic examination of the urine sediment assessed the presence of leukocytes (> 5 fields) and the number of organisms per field observed. A urine culture was used as the reference standard, with significant bacteriuria defined as bacterial growth ≥10⁵ CFU/mL on MacConkey and CLED agar. Additionally, the diagnostic performance of the techniques employed was evaluated by calculating sensitivity, specificity, predictive values, and the concordance index. The prevalence of urinary tract infection was 34.8%. Among the reagent strips evaluated, the Mission (sensitivity: 51.72%; specificity: 87.12%) and ComboStik (sensitivity: 47.13%; specificity: 91.41%) brands demonstrated the best performance for leukocyte esterase detection. Meanwhile, urinary sediment microscopy achieved a sensitivity of 100.00% and a specificity of 88.48% for leukocyte detection. In conclusion, urinary sediment microscopy was the best-performing test for diagnosing urinary tract infections. Among the reagent strips, Mission and ComboStik yielded the best results, particularly regarding the leukocyte esterase parameter.

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