{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T11:53:11Z","timestamp":1765885991594,"version":"3.37.3"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,6,11]],"date-time":"2015-06-11T00:00:00Z","timestamp":1433980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["089275\/Z\/09\/Z"],"award-info":[{"award-number":["089275\/Z\/09\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Published literature from resource\u2010limited settings is infrequent, although urinary tract infections (<jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>) are a common cause of outpatient presentation and antibiotic use. Point\u2010of\u2010care test (<jats:styled-content style=\"fixed-case\">POCT<\/jats:styled-content>) interpretation relates to antibiotic use and antibiotic resistance. We aimed to assess the diagnostic accuracy of <jats:styled-content style=\"fixed-case\">POCT<\/jats:styled-content> and their role in <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content> antibiotic stewardship.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One\u2010year retrospective analysis in three clinics on the Thailand\u2013Myanmar border of non\u2010pregnant adults presenting with urinary symptoms. <jats:styled-content style=\"fixed-case\">POCT<\/jats:styled-content> (urine dipstick and microscopy) were compared to culture with significant growth classified as pure growth of a single organism &gt;10<jats:sup>5<\/jats:sup>\u00a0CFU\/ml.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 247 patients, 82.6% female, the most common symptoms were dysuria (81.2%), suprapubic pain (67.8%) and urinary frequency (53.7%). After excluding contaminated samples, <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content> was diagnosed in 52.4% (97\/185); 71.1% (69\/97) had a significant growth on culture, and &gt;80% of these were <jats:italic>Escherichia coli<\/jats:italic> (20.9% produced extended\u2010spectrum <jats:italic>\u03b2<\/jats:italic>\u2010lactamase (<jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>)). Positive urine dipstick (leucocyte esterase \u22651 and\/or nitrate positive) compared against positive microscopy (white blood cell &gt;10\/<jats:styled-content style=\"fixed-case\">HPF<\/jats:styled-content>, bacteria \u22651\/<jats:styled-content style=\"fixed-case\">HPF<\/jats:styled-content>, epithelial cells &lt;5\/<jats:styled-content style=\"fixed-case\">HPF<\/jats:styled-content>) had a higher sensitivity (99% <jats:italic>vs<\/jats:italic>. 57%) but a lower specificity (47% <jats:italic>vs<\/jats:italic>. 89%), respectively. Combined <jats:styled-content style=\"fixed-case\">POCT<\/jats:styled-content> resulted in the best sensitivity (98%) and specificity (81%). Nearly one in ten patients received an antimicrobial to which the organism was not fully sensitive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>One rapid, cost\u2010effective <jats:styled-content style=\"fixed-case\">POCT<\/jats:styled-content> was too inaccurate to be used alone by healthcare workers, impeding antibiotic stewardship in a high <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content> setting. Appropriate prescribing is improved with concurrent use and concordant results of urine dipstick and microscopy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12541","type":"journal-article","created":{"date-parts":[[2015,5,12]],"date-time":"2015-05-12T04:55:52Z","timestamp":1431406552000},"page":"1281-1289","source":"Crossref","is-referenced-by-count":8,"title":["The role of point\u2010of\u2010care tests in antibiotic stewardship for urinary tract infections in a resource\u2010limited setting on the Thailand\u2013Myanmar border"],"prefix":"10.1111","volume":"20","author":[{"given":"Lauren","family":"Chalmers","sequence":"first","affiliation":[{"name":"Shoklo Malaria Research Unit Faculty of Tropical Medicine Mahidol University Mae Sot Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Cross","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit Faculty of Tropical Medicine Mahidol University Mae Sot 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