{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:27:05Z","timestamp":1790792825634,"version":"4.1.0"},"reference-count":26,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2015,8,1]],"date-time":"2015-08-01T00:00:00Z","timestamp":1438387200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Urinary tract infections (UTIs) and sexually transmitted infections (STIs) are commonly diagnosed in emergency departments (EDs). Distinguishing between these syndromes can be challenging because of overlapping symptomatology and because both are associated with abnormalities on urinalysis (UA). We conducted a 2-month observational cohort study to determine the accuracy of clinical diagnoses of UTI and STI in adult women presenting with genitourinary (GU) symptoms or diagnosed with GU infections at an urban academic ED. For all urine specimens, UA, culture, and nucleic acid amplification testing for\n                    <jats:named-content content-type=\"genus-species\">Neisseria gonorrhoeae<\/jats:named-content>\n                    ,\n                    <jats:named-content content-type=\"genus-species\">Chlamydia trachomatis<\/jats:named-content>\n                    , and\n                    <jats:named-content content-type=\"genus-species\">Trichomonas vaginalis<\/jats:named-content>\n                    were performed. Of 264 women studied, providers diagnosed 175 (66%) with UTIs, 100 (57%) of whom were treated without performing a urine culture during routine care. Combining routine care and study-performed urine cultures, only 84 (48%) of these women had a positive urine culture. Sixty (23%) of the 264 women studied had one or more positive STI tests, 22 (37%) of whom did not receive treatment for an STI within 7 days of the ED visit. Fourteen (64%) of these 22 women were diagnosed with a UTI instead of an STI. Ninety-two percent of the women studied had an abnormal UA finding (greater-than-trace leukocyte esterase level, positive nitrite test result, or pyuria). The positive and negative predictive values of an abnormal UA finding were 41 and 76%, respectively. In this population, empirical therapy for UTI without urine culture testing and overdiagnosis of UTI were common and associated with unnecessary antibiotic exposure and missed STI diagnoses. Abnormal UA findings were common and not predictive of positive urine cultures.\n                  <\/jats:p>","DOI":"10.1128\/jcm.00670-15","type":"journal-article","created":{"date-parts":[[2015,6,11]],"date-time":"2015-06-11T07:32:12Z","timestamp":1434007932000},"page":"2686-2692","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":90,"title":["Overdiagnosis of Urinary Tract Infection and Underdiagnosis of Sexually Transmitted Infection in Adult Women Presenting to an Emergency Department"],"prefix":"10.1128","volume":"53","author":[{"given":"Myreen E.","family":"Tomas","sequence":"first","affiliation":[{"name":"University Hospitals of Cleveland, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"},{"name":"Geriatric Research, Education and Clinical Center, Louis Stokes Veterans Affairs Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damon","family":"Getman","sequence":"additional","affiliation":[{"name":"Hologic, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curtis J.","family":"Donskey","sequence":"additional","affiliation":[{"name":"Geriatric Research, Education and Clinical Center, Louis Stokes Veterans Affairs Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle T.","family":"Hecker","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","first-page":"1","article-title":"National hospital ambulatory medical care survey: 2007 emergency department summary","volume":"26","author":"Niska R","year":"2010","unstructured":"Niska R, Bhuiya F, Xu J. 2010. National hospital ambulatory medical care survey: 2007 emergency department summary. Natl Health Stat Rep 26:1\u201331.","journal-title":"Natl Health Stat Rep"},{"key":"e_1_3_2_3_2","unstructured":"Centers for Disease Control and Prevention. 2013. Sexually transmitted disease surveillance 2012. Centers for Disease Control and Prevention Atlanta GA. http:\/\/www.cdc.gov\/std\/stats12\/surv2012.pdf. Accessed 1 March 2015."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.20.2701"},{"key":"e_1_3_2_5_2","first-page":"1","article-title":"Sexually transmitted diseases treatment guidelines","volume":"59","author":"Workowski KA","year":"2010","unstructured":"Workowski KA, Berman S, Centers for Disease Control and Prevention. 2010. Sexually transmitted diseases treatment guidelines. MMWR Recomm Rep 59 (RR-12):1\u2013110.","journal-title":"MMWR Recomm Rep"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2006.12.010"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198008213030801"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.1996.tb03349.x"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2005.tb01476.x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0b013e31822c10f6"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2013.12.18989"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198208193070802"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-117-2-135"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0087899"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1128\/9781555817435"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu446"},{"key":"e_1_3_2_17_2","unstructured":"Reference deleted."},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.5858\/2008-132-913-UCCACO"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-156-5-201203060-01003"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.12842"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2011.01167.x"},{"key":"e_1_3_2_22_2","first-page":"1589","article-title":"Evaluation of dysuria in adults","volume":"65","author":"Bremnor JD","year":"2002","unstructured":"Bremnor JD, Sadovsky R. 2002. Evaluation of dysuria in adults. Am Fam Physician 65:1589\u20131596.","journal-title":"Am Fam Physician"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1302186"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1086\/427507"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12171"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2012.02.025"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00010-14"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.00670-15","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.00670-15","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,5]],"date-time":"2022-03-05T07:19:38Z","timestamp":1646464778000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/JCM.00670-15"}},"subtitle":[],"editor":[{"given":"R.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2015,8]]},"references-count":26,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2015,8]]}},"alternative-id":["10.1128\/JCM.00670-15"],"URL":"https:\/\/doi.org\/10.1128\/jcm.00670-15","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8]]},"assertion":[{"value":"2015-03-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-06-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-07-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}