Rapid Diagnosis Of Urinary Tract Infections Research Articles

Relationship between urinary track infection screening tests and urine culture results in patients with suspect urinary track infection

Background: Urinary tract infection (UTI) is a common disease found in the world. Gold standard for the diagnosis of UTI is urine culture, but this examination has the disadvantage of taking longer results. As a screening test, urine dipstick and urine flowcytometry provide more rapid diagnosis of UTI. Objectives: The purpose of this study was to determine the relationship between the results of the dipstick test and UF4000 with urine culture. Materials and Methods: This study used an analytic observational method with a cross sectional approach, with accidental sampling. The samples obtained was 38 samples from patients at the Clinical Laboratory of Prodia Diponegoro and Prodia SDP. Results: The results showed that there was 84.2% concordance between leukocyte esterase results and culture results, and 31.6% concordance between nitrite results and culture results, 97.4 5% concordance between urine flowcytometry results and urine culture results. Conclusions: Based on the Chi square statistical, it was concluded that there were relationship between Urine culture and leukocyte esterase (p-value 0.000), nitrite (p-value 0.004, urine flowcytometri (p-value 0.000). Both of these screening tests can be used to help diagnose UTI, but the gold standard for UTI still uses urine culture result.

Antimicrobial Agent Functional Gold Nanocluster-Mediated Multichannel Sensor Array for Bacteria Sensing.

Urinary tract infections (UTIs) have greatly affected human health in recent years. Accurate and rapid diagnosis of UTIs can enable a more effective treatment. Herein, we developed a multichannel sensor array for efficient identification of bacteria based on three antimicrobial agents (vancomycin, lysozyme, and bacitracin) functional gold nanoclusters (AuNCs). In this sensor, the fluorescence intensity of the three AuNCs was quenched to varying degrees by the bacterial species, providing a unique fingerprint for different bacteria. With this sensing platform, seven pathogenic bacteria, different concentrations of the same bacteria, and even bacterial mixtures were successfully differentiated. Furthermore, UTIs can be accurately identified with our sensors in ∼30 min with 100% classification accuracy. The proposed sensing systems offer a rapid, high-throughput, and reliable sensing platform for the diagnosis of UTIs.

English

This paper compares, in a hub and spoke (H&S) setting, the performance of two automated methods in rapid diagnosis of urinary tract infections (UTI). 2335 midstream urine samples obtained from adult patients were considered. In the spoke laboratory, rapid diagnosis of UTI was performed by using bacteria quantification with a Sysmex UF-1000i analyzer. In the hub laboratory, rapid diagnosis of UTI was performed by using Alifax Alfred and HB&L analyzer. Moreover, in the hub laboratory, a quantitative culture was performed in all samples. Using UF-1000i with a cut-off at 175 bacteria/µl, sensitivity was (SE) 0.95, specificity (SP) 0.80, negative predictive value (NPV) 0.98, positive predictive value (PPV) 0.64, and diagnostic accuracy (DA) 0.84. Using Alifax Alfred and HB&L with a cut-off at 30000 bacteria/ml, SE was 0.99, SP 0.99, NPV 0.99, PPV 0.98 and DA 0.98. In an H&S setting, UTI screening with UF-1000i is acceptable for routine applications. In our setting, after implementation of an UF-1000i based UTI screening, the number of bacterial cultures was thought to be reduced to 50%. Therefore, using the Alifax Alfred and HB&L system, with a higher SP, it was assumed that there is need to carry out further urine microbiological tests, allowing to perform reliable samples of about 70%. Another relevant positive aspect may be the availability of the negative results within 9 to 10 h after samples collection. Key words: Bacteriuria, rapid diagnosis, urinalysis, urinary tract infection.

Precisão da tira reagente e do exame microscópico da urina no diagnóstico de infecções do trato urinário em porcas

O diagnóstico de infecção do trato urinário (ITU) em porcas geralmente é feito com o auxílio de tiras reagentes, por ser um método rápido, prático e passível de ser realizado na própria granja. O exame microscópico da urina raramente é utilizado em granjas por ser uma técnica mais demorada e trabalhosa. No entanto, não existem estudos sobre a precisão destas duas técnicas no diagnóstico de ITU nesta espécie. O objetivo deste estudo foi avaliar a precisão da tira reagente e do exame microscópico da urina no diagnóstico de ITU em porcas, comparando-os com o exame bacteriológico da urina. Para selecionar as porcas que iriam compor o estudo foi realizado um exame químico prévio com tira reagente, do qual foram selecionadas 139 porcas, 66 positivas para nitrito na tira reagente e 73 negativas. No dia seguinte foi realizada uma nova coleta de urina destas 139 porcas para realização da urinálise completa, que incluiu os exames físico, químico, microscópico e microbiológico destas amostras de urina. Os resultados demonstraram que a prova de nitrito da tira reagente apresentou 100% de especificidade e 93% de sensibilidade. A especificidade do exame microscópico para bacteriúria foi de 82% e a sensibilidade de 100%. O diagnóstico de ITU com o uso de tiras reagentes e/ou com exame microscópico da urina é confiável, quando comparado com o exame bacteriológico da urina, o que torna possível o diagnóstico rápido de ITU em porcas na granja.

Measurement of urinary lactoferrin as a marker of urinary tract infection.

The usefulness of the measurement of urinary lactoferrin (LF) released from polymorphonuclear leukocytes and of an immunochromatography test strip devised for measuring urinary LF for the simple and rapid diagnosis of urinary tract infections (UTI) was evaluated. Urine specimens were collected from apparently healthy persons and patients diagnosed as suffering from UTI. In the preliminary study, the LF concentrations in 121 normal specimens and 88 specimens from patients (60 with UTI) were quantified by an enzyme-linked immunosorbent assay. The LF concentration was 3,300.0 +/- 646.3 ng/ml (average +/- standard error of the mean) in the specimens from UTI patients, whereas it was 30.4 +/- 2.7 ng/ml and 60.3 +/- 14.9 ng/ml in the specimens from healthy persons and the patients without UTI, respectively. Based on these results, a 200-ng/ml LF concentration was chosen as the cutoff value for negativity. Each urine specimen was reexamined with the newly devised immunochromatography (IC) test strip to calculate the indices of efficacy. Based on the cutoff value, it was calculated that the sensitivity, specificity, and positive and negative predictive values of the IC test were 93.3, 89.3, 86.2, and 94.9%, respectively, compared with the results of the microscopic examination of the urine specimens for the presence of leukocytes. The respective indices for UTI were calculated as 95.0, 92.9, 89.7, and 96.6%. The tests were completed within 10 min. These results indicated that urine LF measurement with the IC test strip provides a useful tool for the simple and rapid diagnosis of UTI.