Abstract
Objective: Urinary tract infection diagnosis by urine culture can be time- and labor- consuming. In the National Kidney and Transplant Institute, up to 75% of urine culture samples sent to the laboratory yield no growth or insignificant growth. A rapid and reliable screening method to rule out bacterial UTI could reduce culture workload, turnaround time of negative results and also unnecessary antibiotic prescription. Sysmex UF-1000i is urine flow cytometry analyzer which is capable of quantifying urine particles including bacteria and leukocytes. We evaluated the UF-1000i performance for ruling out UTIs and its bacterial scattergram feature to estimate the causative bacterial group, using standard urine culture results as reference method. Methods: 293 urine samples were analyzed using Sysmex UF-1000i analyzer and compared with urine culture results. Bacterial cluster distribution in the bacterial scattergram of positive cultures was also analyzed for causative bacterial class estimation. Results: Out of 293 urine samples, 104 (35.5%) samples had bacterial growth of more than 103 CFU/ml on culture and most common organism isolated was Escherichia coli (28.8%). The optimum bacterial cut off value of 55/μl and/or leukocytes cut-off value of 27/μl were observed using ROC analysis to rule out UTI. The bacterial scattergram analysis showed 82.7% concordance with the results of the urine culture, with only 5.8% discordant results, and 11.5% had results showing non-specific or wide distribution patterns near the 30° angle. Conclusions: Urine samples can be routinely screened for UTI using the Sysmex UF-1000i, and this can improve the overall turnaround time of negative results and reduce laboratory culture workload
Highlights
Urinary tract infection (UTI) is a common medical problem and may range from asymptomatic bacteriuria to severe infection that can lead to serious complications when left untreated
The optimum bacterial cut off value of 55/μl and/or leukocytes cut-off value of 27/μl were observed using Receiving operator characteristics (ROC) analysis to rule out UTI
Urine samples can be routinely screened for UTI using the Sysmex UF-1000i, and this can improve the overall turnaround time of negative results and reduce laboratory culture workload
Summary
Urinary tract infection (UTI) is a common medical problem and may range from asymptomatic bacteriuria to severe infection that can lead to serious complications when left untreated. Women are more likely to be affected than men [1]. Specific subpopulations are at increased risk of UTI, including infants and children, pregnant women, diabetic and immunocompromised patients, the elderly and those with underlying urologic abnormalities [1]. Prompt diagnosis is important for proper and timely management. Urine culture is considered to be the gold standard to diagnose UTI. The performance of urine culture is laborious and time consuming, with results usually released after 3 to 4 days. Studies have proven that up to 80% of urine samples subjected to urine culture are reported negative for bacteria which make urine culture less cost-effective [2]
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