Diagnostic Correlation of Urine Microscopy with Urine Culture in the Detection of Urinary Tract Infection: A Cross-Sectional Study from A Tertiary Care Hospital in Rajasthan

Background: Urinary tract infection (UTI) is among the most common bacterial infections encountered in clinical practice and contributes substantially to patient morbidity and healthcare burden. Urine culture is considered the gold standard for diagnosis; however, it is time-consuming and resource-intensive. Urine microscopy is frequently used as a rapid and economical screening tool, especially in resource-limited settings. The present study was conducted to evaluate the correlation between urine microscopy and urine culture in the detection of urinary tract infection.

Objectives: To assess the correlation between urine microscopy findings and urine culture results in patients suspected of urinary tract infection and to determine the diagnostic utility of urine microscopy in predicting culture-positive UTI.

Methods: A hospital-based observational cross-sectional study was conducted in a tertiary care hospital in Rajasthan from February 2026 to April 2026 among 380 patients clinically suspected of urinary tract infection. Demographic and clinical details were recorded using a predesigned proforma. Clean-catch midstream urine samples were subjected to routine urine microscopy and urine culture examination in the Department of Pathology using standard laboratory procedures. Significant pyuria was defined as more than 5 pus cells per high-power field, while significant bacteriuria on culture was considered at ≥10^5 CFU/mL. Statistical analysis was performed using SPSS version 26.0. Chi-square test was used to assess association, and diagnostic validity parameters were calculated using urine culture as the reference standard. A p-value <0.05 was considered statistically significant.

Results: Among 380 participants, females constituted 62.6% of cases, and the majority belonged to the 21–40 years age group. Dysuria was the most common presenting complaint (66.8%). Pyuria on urine microscopy was observed in 56.3% participants, while urine culture positivity was detected in 42.6% cases. A statistically significant association was found between pyuria and urine culture positivity (χ² = 72.4, p <0.001). Urine microscopy demonstrated a sensitivity of 84.0%, specificity of 64.2%, positive predictive value of 63.6%, and negative predictive value of 84.3% for detection of culture-positive urinary tract infection.

Conclusion: Urine microscopy showed significant correlation with urine culture and demonstrated good sensitivity for screening urinary tract infection. It can serve as a rapid, economical, and useful preliminary diagnostic tool in tertiary healthcare settings. However, urine culture remains essential for definitive diagnosis and antimicrobial susceptibility testing.