Different Laboratory Diagnostic Procedures Including PCR Directly from Urine Specimens from Suspected Patients of UTI

Abstract

Background: Urinary tract infection (UTI) is among the most common bacterial infections and possess significant healthcare burden. Hence a study was necessary to apply PCR technology directly to clinical specimens to allow early and accurate identification of pathogens of UTI. Objective: Diagnosis of major uropathogens by different laboratory diagnostic procedures including polymerase chain reaction (PCR) directly from urine specimens from suspected patients of urinary tract infection. Methods: This study was carried out in the department of Microbiology, Mymensingh Medical College during the period from July 2016 to June 2017. Urine specimens were collected and isolation and identification of major uropathogens (Escherichiacoli Klehsiella pneumonias, Proteusmirabilis, and Pseudomonas aeruginosa) were done by standard microbiological procedure anbiochemical tests. PCR was performed by using standard protocol with species specific primer for detection offim H gene for Escherichia coli, fimK gene for Klehsiella paeunomiae, UreC for Proteus mirabilis and ETA for Pseudomonas aeruginasa. Results: Out of 250 urine specimens, 200 specimens were isolated and identified by culture and different biochemical methods which were supported by microscopical examination and at the same time PCR could detect species specific genes in 201 specimens directly from urine of suspected UTI patient Escherichia coli was responsible as a leading causative pathogen in both outpatient department and in patient department. Urine specimens was higher in female in both out patient population and inpatient population. Culture positivity of in patient population among the male (45.5%) was slighty higher than that of outpatient population (34.5%). The predominant age group suffered from UTI in case of outpatient population was >15-30 but for the in patient population, the age group was 60 years and above. 90 culture positive in patient population, 43 (95.5%) were from the gynae unit, 23 (92%) were from surgery unit, 8 (72.7%) were from the medicine unit, 12 (85.7%) were from orthopaedic unit and 4 (80%) were from paediatric unit. On the other hand Pseudomonas aeruginosa Profeus mirabilis and Klebsiella pneumonia were more prevalent in in-patient department and it was 21.1%, 5.6% and 5.5% respectively, Among the 50 culture negative urine specimens, 14 (28%) showed PCR positive for Escherichia coli, Klehsiella pneumonia and Pseudomonas aeruginosa. Conclusion: This study revealed that, the prevalence of UTI is high n MMCH Single pathogen base uniplex PCR was found superior than standard culture and less time consuming. Because uniplex PCR could detect many (28%) culture negative cases.