Early Detection Of Urinary Tract Infection Research Articles

A clinical prediction tool to predict urinary tract infection in pediatric febrile patients younger than 2 years old: a retrospective analysis of a fever registry.

ObjectiveUrinary tract infection (UTI) is a significant issue in young febrile patients due to potential long-term complications. Early detection of UTI is crucial in pediatric emergency departments (PEDs). We developed a tool to predict UTIs in children.MethodsClinical data of patients <24 months of age with a fever and UTI or viral infection were extracted from the fever registry collected in two PEDs. Stepwise multivariate logistic regression was performed to establish predictors of identified eligible clinical variables for the derivation of the prediction model.ResultsA total of 1,351 patients were included in the analysis, 643 patients from A hospital (derivation set) and 708 patients from B hospital (validation set). In the derivation set, there were more girls and a lower incidence of a past history of UTI, older age, less fever without source, and more family members with upper respiratory symptoms in the viral infection group. The stepwise regression analysis identified sex (uncircumcised male), age (≤12 months), a past history of UTI, and family members with upper respiratory symptoms as significant variables.ConclusionYoung febrile patients in the PED were more likely to have UTIs if they were uncircumcised boys, were younger than 12 months of age, had a past history of UTIs, or did not have families with respiratory infections. This clinical prediction model may help determine whether to perform urinalysis in the PED.

Impact of Sequential Passaging on Protein Expression of E. coli Using Proteomics Analysis.

Urinary tract infection (UTI) is one of the most prevalent bacterial infections in the world affecting the bladder and the kidney. Escherichia coli (E. coli) is the main causative agent of 80–90% of community-acquired UTIs, about 40% of nosocomial UTIs, and 25% of recurrent UTIs. The field of proteomics has emerged as a great tool to analyze expressed proteins to identify possible biomarkers associated with many pathological states and, to the same extent, those associated with bacterial pathogenesis and their ability to cause recurrent infections. Here, in a descriptive cross-sectional pilot study, we employed proteomic techniques to investigate the effects of environmental stress on protein profiles of E. coli simulated by sequential passaging of samples from patients with UTIs to screen for unique proteins that arise under stressful environment and could aid in the early detection of UTIs. Four urine samples were collected from individuals with recurrent UTI and sequentially subcultured; protein samples were extracted from bacterial pellets and analyzed using 2-dimensional gel electrophoresis (2DGE). Protein spots of interest arising from changes in the protein profile were analyzed using liquid chromatography-mass spectrometry (LC-MS/MS) and matched against known databases to identify related proteins. We identified ATPB_ECOBW, ASPA ECOLI, DPS ECOL6, and DCEB ECOLI as proteins associated with higher passaging. We concluded that passaging resulted in identifiable changes in the protein profile of E. coli, namely, proteins that are associated with survival and possible adaptation of bacteria, suggestive of factors contributing to antibiotic resistance and recurrent UTIs. Furthermore, our method could be further used to identify indicator-protein candidates that could be a part of a growing protein database to diagnose and identify causative agents in UTIs.

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

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.

Diaper-Embedded Urinary Tract Infection Monitoring Sensor Module Powered by Urine-Activated Batteries

Urinary tract infection (UTI) is one of the most common infections in humans. UTI is easily treatable using antibiotics if identified in early stage. However, without early identification and treatment, UTI can be a major source of serious complications in geriatric patients, in particular, those suffering from neurodegenerative diseases. Also, for infants who have difficulty in describing their symptoms, UTI may lead to serious development of the disease making early identification of UTI crucial. In this paper, we present a diaper-embedded, wireless, self-powered, and autonomous UTI monitoring sensor module that allows an early detection of UTI with minimal effort. The sensor module consists of a paper-based colorimetric nitrite sensor, urine-activated batteries, a boost dc-dc converter, a low-power sensor interface utilizing pulse width modulation, and a Bluetooth low energy module for wireless transmission. Experimental results show a better detection of nitrite, a surrogate of UTI, than that of conventional dipstick testing. The proposed sensor module achieves a sensitivity of 1.35 ms/(mg/L) and a detection limit of 4 mg/L for nitrite.

Urinary tract infection in children: clinical aspects and utility of urine dipstick test

Background: Urinary tract infection (UTI) is a common genitourinary disease in children and accounts for significant morbidity. To prevent the potentially dangerous sequel, early detection of UTI in childhood is essential. This depends entirely on strong clinical suspicion and urine culture report. Recently, advances in investigations are taking place to diagnose UTI rapidly. Urine dipstick is one such bedside method to diagnose UTI. This study aims at studying the clinical features of UTI and evaluating sensitivity and specificity of urine dipstick in diagnosing UTI.Methods: This study was conducted at a tertiary care hospital in Vadodara from January 2013 to June 2014, on 60 children admitted with clinical suspicion of urinary tract infection. Along with study of clinical features, results of urine dipstick tests (Nitrite and Leukocyte esterase), urine microscopy and urine culture were compared. Accuracy of urine dipstick tests was assessed statistically by evaluating sensitivity, specificity, positive and negative predictive values considering urine culture as a gold standard.Results: Fever was found to be the most common presenting features (53%) in all the patients studied. The sensitivity of urine microscopy, Nitrite test and Leucocyte esterase test was 63.5%, 50% and 61% and specificity was 25%, 31% and 25% respectively. Combination of Nitrite and Leucocyte Esterase test had an improved sensitivity (68%).Conclusions: Urinary tract infection can present with variety of non-specific signs and symptoms especially in younger age. Dipstick test using Leucocyte Esterase and Nitrite together is better than urine microscopic examination alone. Urine culture as a confirmatory test still remains gold standard.

Diagnostic test of urine clarity in urinary tract infection

Background Early detection and prompt treatment are manda-tory in managing urinary tract infection (UTI). Failure to early de-tect ion of UTI may result in declining of kidney function. Urineculture is the gold standard to diagnose UTI, but it takes 3-5 daysto obtain the results. The turbidity of urine describes the presenceof bacteria or leukocytes in urine. It is important to determine therelationship between the urine clarity by visual examination andthe absence of bacteriuria.Objective To evaluate the diagnostic value of urine clarity by vi-sual examination in diagnosing UTI.Methods We conducted a prospective study in emergency careunit, outpatient department, and children wards of Sardjito Hos-pital, Yogyakarta. The urine specimen was collected from chil-dren under 15 years old by catheterization or midstream urinecollections. Two independent observers evaluated the urine clar-ity by the standard technique. Statistical analysis was assignedto calculate the sensitivity, specificity, positive and negative pre-dictive values, and likelihood ratio. Kappa index was used to evalu-ate the agreement between two observers in determining the urineclarity.Results Two-hundred and five children were enrolled in this study.Urine clarity in diagnosing UTI produced sensitivity of 78% (95%CI 69;87), specificity of 84.5% (95% CI 78;91), positive predictivevalue (PPV) of 77.1% (95% CI 68;86), negative predictive value(NPV) of 85.2% (95% CI 79;92), positive likelihood ratio of 5.03(95% CI 3.29;7.76), and negative likelihood ratio of 0.26 (95% CI0.17;0.39).Conclusion Urine clarity is sufficiently accurate as a diagnostictest for UTI. The diagnostic value of urine clarity is expected to beuseful for clinicians to detect UTI earlier and to guide them in mak-ing decision for clinical management.

Invasive disease caused by Haemophilus parainfluenzae III in a child with uropathy

Urinary tract infections (UTIs) caused by Haemophilus parainfluenzae represent a very small percentage of this kind of pathology in children, and it has scarcely been described in the medical literature. According to previous studies of over 800 urine samples in children under 15 years old, a decrease of 50% (from 0.13% to 0.07%) is estimated in its occurrence over the last two decades. This can be explained by the early detection of UTIs and their early empirical treatment, because this micro-organism shows high sensitivity to antibiotics. Also, the culture media in which this bacterium grows are not included in most current protocols. Here we report a case of a UTI caused by H. parainfluenzae in a 4-year-old boy.

Can the Griess Nitrite Test and a Urinary Pus Cell Count of ≥5 Cells Per Micro Litre of Urine in Pregnant Women be Used for the Screening or the Early Detection of Urinary Tract Infections in Rural India?

Urinary Tract Infection (UTI) is a common problem in pregnancy due to the morphological and the physiological changes that take place in the genitourinary tract during pregnancy. Screening methods may be useful, because a full bacteriological analysis could be reserved for those patients who are symptomatic or those who have positive screening test results. The exact prevalence of UTI in rural, pregnant women is unknown. The present study was undertaken to estimate the prevalence of UTI in pregnant women and for ascertaining the utility of the Griess Nitrite test and the Urinary Pus Cell Count of ≥5 cells per micro litre test for the screening or the early detection of UTI in them at primary health care clinics. Occurrence of urinary complaints was compared in UTI and non UTI women. We conducted a study on 300 randomly selected, pregnant women from rural areas. Urine cultures, pus-cell counts and the Griess nitrite test were used for diagnosis of UTI. The screening tests for UTI were evaluated in terms of their sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and the percentage of correctly classified. In the present study, the prevalence of UTI was found to be 29/300 (9.6%, 95% confidence interval 9.57-9.63). The specificities of the two screening tests were comparable (97.05% and 94.47%). Also, the negative predictive values of the two tests were almost similar (97.77% and 96.96%). The percentage of correctly classified by the Griess nitrite test and the urine pus cell count were found to be 95.33% and 92.33% respectively. The proportion of the women with various urinary complaints was significantly higher (P<0.00) in the UTI subjects as compared to that in the non-UTI subjects. Urine culture remains the gold standard for the detection of asymptomatic bacteriuria. The Nitrite test of uncentrifuged urine was observed to be the best among the screening tests which were evaluated in terms of their efficiency and validity.

Clinical Validation of Integrated Nucleic Acid and Protein Detection on an Electrochemical Biosensor Array for Urinary Tract Infection Diagnosis

BackgroundUrinary tract infection (UTI) is a common infection that poses a substantial healthcare burden, yet its definitive diagnosis can be challenging. There is a need for a rapid, sensitive and reliable analytical method that could allow early detection of UTI and reduce unnecessary antibiotics. Pathogen identification along with quantitative detection of lactoferrin, a measure of pyuria, may provide useful information towards the overall diagnosis of UTI. Here, we report an integrated biosensor platform capable of simultaneous pathogen identification and detection of urinary biomarker that could aid the effectiveness of the treatment and clinical management.Methodology/Principal FindingsThe integrated pathogen 16S rRNA and host lactoferrin detection using the biosensor array was performed on 113 clinical urine samples collected from patients at risk for complicated UTI. For pathogen detection, the biosensor used sandwich hybridization of capture and detector oligonucleotides to the target analyte, bacterial 16S rRNA. For detection of the protein biomarker, the biosensor used an analogous electrochemical sandwich assay based on capture and detector antibodies. For this assay, a set of oligonucleotide probes optimized for hybridization at 37°C to facilitate integration with the immunoassay was developed. This probe set targeted common uropathogens including E. coli, P. mirabilis, P. aeruginosa and Enterococcus spp. as well as less common uropathogens including Serratia, Providencia, Morganella and Staphylococcus spp. The biosensor assay for pathogen detection had a specificity of 97% and a sensitivity of 89%. A significant correlation was found between LTF concentration measured by the biosensor and WBC and leukocyte esterase (p<0.001 for both).Conclusion/SignificanceWe successfully demonstrate simultaneous detection of nucleic acid and host immune marker on a single biosensor array in clinical samples. This platform can be used for multiplexed detection of nucleic acid and protein as the next generation of urinary tract infection diagnostics.

Identifying Bacteria in Human Urine: Current Practice and the Potential for Rapid, Near-Patient Diagnosis by Sensing Volatile Organic Compounds

Urinary tract infection (UTI) represents a significant burden for the National Health Service. Extensive research has been directed towards rapid detection of UTI in the last thirty years. A wide range of microbiological and chemical techniques are now available to identify and quantify bacteria in urine. However, there is a clear and present need for near, rapid, sensitive, reliable analytical methods, preferably with low-running costs, that could allow early detection of UTI and other diseases in urine. Here we review the "state of the art" of current practice for the detection of bacteria in urine and describe the advantages of the recent "e-nose" technology as a potential tool for rapid, near-patient diagnosis of UTI, by sensing volatile organic compounds (VOCs).

The use of urinary dipstix in children with high-risk renal tracts.

Urinary tract infection (UTI) is one of the most common acute illnesses found in infants and children and up to 5% of girls and 1% of boys will experience one or more episodes. Bables and children with abnormal renal tracts are at risk of developing scarred kidneys as a result of recurrent UTI, leading to an increased risk of hypertension and end-stage renal failure in later life. It seems logical, therefore, to place high priority on the early detection, prompt treatment and adequate follow up of children with high-risk renal tracts. This article describes the use of home urine testing for the early detection of UTI in children with high-risk renal tracts.

Electrochemical method for the early detection of urinary-tract infections.

A method for detecting the presence of bacteria in urine based on measuring a change in potential between two electrodes was tested in a clinical microbiology laboratory. Initial tests were conducted with 13 bacteria commonly associated with urinary-tract infections; all of the test organisms were detected within 2--9 hours. A linear relationship was established between inoculum size and the time an increase in voltage was observed on a strip-chart recorder. No response was seen with sterile urine, but urine samples inoculated with Escherichia produced the expected positive response. One hundred twenty-eight urine specimens from hospitalized persons were simultaneously tested by the electrochemical detection method (ECDM) and by conventional bacteriologic procedures. Ninety-four per cent of 49 positive samples with counts of 10(5) organisms per ml. or more were detected within 4 hours and 100% at 10 hours with the ECDM. Twenty-nine specimens with counts less than 10(5) cells per ml. were detected in 3.5 to 9 hours; two samples (8%) in this group were positive within 4 hours. Fifty samples were negative for bacterial growth, and no increase in voltage was found with these samples.