A new point-of-care test for the rapid detection of urinary tract infections

Alyexandra Arienzo,Valeria Ferrante,Michela Orrù,Vincenzo Ziparo,Francesca Losito,Ottavia Stalio,Valentina Cellitti,Flavia Cristofano,Lorena Silvestri,Lorenza Murgia,Giovanni Antonini,Rossella Marino,Paolo Visca,Salvatore Di Somma

doi:10.1007/s10096-019-03728-3

Abstract

Urinary tract infections (UTIs) are among the most common infections in all age groups. Fast and accurate diagnosis is essential to ensure a timely and effective therapy. Alongside with reference culture-based methods, several point-of-care tests (POCTs) for early detection of UTIs have been developed, but they have not been significantly implemented in current clinical practice. The Micro Biological Survey (MBS) POCT is a simple test developed by MBS Diagnostics Ltd. (London, UK) for the detection and management of UTIs. The present study has been undertaken to investigate the potentials and limits of the MBS POCT. A total of 349 patients were enrolled in two open-label, monocentric, non-interventional clinical trials in collaboration with an Emergency Medicine department and the outpatient clinic of two hospitals in Rome. Results of urine analysis using the MBS POCT were compared with those of the routine culture-based tests for UTI diagnosis performed by the hospital laboratory. The MBS POCT provided fast results revealing high bacterial count UTIs (≥ 105 CFU/ml) with 97% accuracy, 92% sensitivity, 100% specificity, 99% PPV, and 96% NPV within a 5-h analytical time threshold.

Highlights

Urinary tract infections (UTIs) remain a major public health problem being among the most common infections in all age groups
Upon receiver operating characteristic (ROC) curve analysis, the area under the ROC curve (AUC) of the Micro Biological Survey (MBS) point-of-care tests (POCTs) was 0.987 (Fig. 1), and the associated criterion was 5.24 h
The diagnostic accuracy of the MBS POCT was investigated in different clinical settings in order to highlight the potential benefits and limits of the new method in comparison with conventional urine culture, considered as the gold standard

Summary

Introduction

Urinary tract infections (UTIs) remain a major public health problem being among the most common infections in all age groups. UTI patients are empirically treated with antibiotics, and guidelines recommend starting antibiotic treatment before urine culture and AST results become available, delaying by ca. The empirical antimicrobial regimen of choice should be based on local resistance patterns, as highlighted in various studies from different countries, to effectively prevent the emergence of multi-drug-resistant uropathogens [10,11,12,13]. For these reasons, fast and accurate diagnosis, leading to a rational treatment, is essential to achieve a timely and effective therapy

Methods

Results

Conclusion