MP34-06 THE ROLE OF MICROGENDX TESTING IN PATIENTS WITH LOWER URINARY TRACT SYMPTOMS AND NEGATIVE STANDARD URINE CULTURES

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP34-06 THE ROLE OF MICROGENDX TESTING IN PATIENTS WITH LOWER URINARY TRACT SYMPTOMS AND NEGATIVE STANDARD URINE CULTURES Rahul Dutta, Wyatt Whitman, Maxwell Sandberg, Stephen Walker, and Catherine Matthews Rahul DuttaRahul Dutta More articles by this author , Wyatt WhitmanWyatt Whitman More articles by this author , Maxwell SandbergMaxwell Sandberg More articles by this author , Stephen WalkerStephen Walker More articles by this author , and Catherine MatthewsCatherine Matthews More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003268.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients with acute lower urinary tract symptoms (LUTS) and a negative standard urinary culture are challenging to manage. Some may have identifiable organisms on urinary polymerase-chain reaction (PCR) testing or next-generation DNA sequencing (NGS). We sought to better understand the relationship between patients with negative UC and positive (with an identifiable microbe) PCR/NGS that had treatment for LUTS directed towards the organism(s) on PCR/NGS. METHODS: Patients from a single academic center for which a MicroGenDX PCR/NGS sample was analyzed were retrospectively reviewed. Relationships between demographics, UC and urinalysis data, symptomatology, treatment data, and comorbidities were analyzed. RESULTS: A total of 122 patients were reviewed, of which 116 (95%) had identifiable bacteria and 17 (14%) had identifiable fungi on urinary PCR/NGS. Of these, 95 (81% female) had both negative UC and identifiable microbes on PCR/NGS and were therefore included in the following analysis. The most common reasons for urologic consultation were recurrent urinary tract infection (UTI, 27%), stone disease (21%), and LUTS (18%). Leukocytes were identified on 44% of patients who had a urinalysis at the time of PCR/NGS with negative UC. Forty-seven (54%) patients were treated with antimicrobials following PCR/NGS and 25 of them (53%) had resolution or improvement in their symptoms. There was no association between treatment success and gender, interstitial cystitis, stone disease, diabetes mellitus, vaginal prolapse beyond the hymen, menopausal status, vaginal estrogen use, or overactive bladder syndrome (p>0.05). There was no association between the presence of moderate or greater leukocytes on urinary dipstick and likelihood of symptomatic resolution with treatment (p>0.05). There was a trend to increased likelihood of symptomatic resolution in patients with identifiable fungi on UPCR (p=0.1131). CONCLUSIONS: In the small present study, most patients with lower urinary tract symptoms and a negative standard urine culture have identifiable pathologic microbes on urinary PCR/NGS testing. The clinical utility of PCR/NGS testing, however, is unclear as symptomatic improvement with targeted antimicrobial treatment occurred in only approximately half of these patients. No relationships with treatment success, urinalysis findings, or common medical comorbidities were found. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e461 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rahul Dutta More articles by this author Wyatt Whitman More articles by this author Maxwell Sandberg More articles by this author Stephen Walker More articles by this author Catherine Matthews More articles by this author Expand All Advertisement PDF downloadLoading ...