Use of Clinical Findings in Diagnosis of Urinary Tract Infection in Women-Reply

—Coagulase-negative staphylococci accounted for 16% of the organisms cultured in our study population. At the time of the study, resistance to novobiocin was not routinely tested. We first analyzed the pilot study results excluding all coagulase-negative staphylococci and then reanalyzed the data identifying them as pathogens if the colony count exceeded 10⁵ colony-forming units (CFU). We found no difference in the sensitivity and specificity of signs and symptoms when the staphylococci were included and, therefore, included them in deriving the decision rule. Cutoff points of both 10⁴ and 10⁵ CFU were analyzed, with no resulting difference in the rule. These results were consistent with the findings of Latham et al1 who found no difference in the clinical findings of patients with Staphylococcus saprophyticus infections compared with those with Escherichia coli infections.

Thirty-three percent of the patients seen in the emergency department had a pelvic examination. The