scholarly journals Evaluation of a phenotypic, point-of-care solution for the detection and quantitative antibiotic susceptibility testing for lower Urinary Tract Infection

2021 ◽  
Author(s):  
Ronal Turner ◽  
Rachel Kirkby ◽  
Emma Meader ◽  
John R Wain
Keyword(s):  
Urinary Tract ◽  
Predictive Value ◽  
Antibiotic Susceptibility ◽  
Point Of Care ◽  
Urine Samples ◽  
Reference Laboratory ◽  
Sensitivity Testing ◽  
Treatment Data ◽  
Culture And Sensitivity ◽  
Tract Infections

Background Urinary tract infections (UTIs) are one of the most common bacterial infections seen in primary care. The current standard for the definitive diagnosis of a UTI is culture and sensitivity testing of a mid-stream urine sample at a clinical laboratory; however, this technique is costly, labour intensive and is not directly relevant clinically - typically taking 2-3 days to yield a result. Study design and Objective This is a nonexperimental cross-sectional study. The aim of this study was to evaluate the efficacy of U-treat, a bioluminescent approach for rapid detection of bacteriuria and quantitative determination of the antimicrobial susceptibility profiles of uropathogens in clinical urine specimens - in under an hour. Method The evaluation was carried out in two UK-based Medical Centres using urine samples from patients presenting with symptoms of a UTI (n=249). The U-treat technology is a two test, two reagent process. Test 1 detects the presence of a bacterial UTI > 104 bacteria/mL (5-10 minutes). Test 2 produces quantitative antibiotic susceptibility (<50 minutes). Only urine samples testing positive for bacteria in Test 1 underwent Test 2 (n=82). U-treat results were compared retrospectively against reference laboratory culture and sensitivity findings. The influence of the technology on patient treatment outcomes was also analysed. Results Relative to reference laboratory analysis, Test 1 showed a sensitivity of 97.1% and specificity of 92.0%. (PPV: 89.3%; NPV: 97.8%). Test 2 produced an overall sensitivity (measurement of true susceptibility) of 94.1% (Predictive value: 96%) and an overall specificity (measurement of true resistance) of 90.5% (Predictive value 86.4%). Analysis of treatment data demonstrated that had the physicians had access to U-treat results at the point of care, the percentage of patients treated successfully would have risen from 68.3% to 92.7%. Conclusion U-treat represents the first technology, world-wide, capable of providing UTI treatment data to physicians at the point of care, in less than 60 minutes.

scholarly journals Bacterial Infection Diagnosis and Antibiotic Prescription in 3 h as an Answer to Antibiotic Resistance: The Case of Urinary Tract Infections

Antibiotics ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1168
Author(s):  
Eleonora Nicolai ◽  
Massimo Pieri ◽  
Enrico Gratton ◽  
Guido Motolese ◽  
Sergio Bernardini
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antimicrobial Susceptibility ◽  
Antibiotic Susceptibility ◽  
Clinical Laboratory ◽  
Point Of Care ◽  
Urine Samples ◽  
Clinical Approach ◽  
Antibiotic Susceptibility Test ◽  
Tract Infections

Current methods for the diagnosis of urinary tract infections with antimicrobial susceptibility testing take 2–3 days and require a clinical laboratory. The lack of a rapid, point-of-care antibiotic susceptibility test (AST) has contributed to the misuse of antibiotics when treating urinary tract infections (UTIs) and consequently to the rise of multi-drug-resistant organisms. The current clinical approach has led to reduced treatment options and increased costs of diagnosis and therapy. To address this issue, novel diagnostics are needed for the timely determination of antimicrobial susceptibility. We present a rapid, point-of-care, phenotypic AST device that can report the antibiotic susceptibility/resistance of a uropathogen to a panel of antibiotics in as few as 3 h by utilizing fluorescent-labelling chemistry and a highly sensitive particle-counting instrument. We analysed 744 urine samples from the outpatients and inpatients of two Italian hospitals. The 130 UTI-positive patient urine samples we found were measured using a panel of six common UTI antibiotics plus a growth control. By comparing our results to hospital laboratory urine cultures, we obtained an overall sensitivity = 81%, a specificity = 83%, an SPV (sensitivity predicted value) = 95%, and an RPV (resistance predicted value) = 54%. According to our preliminary data, the sensitivity predicted value for a single antibiotic agent was 95%, thus allowing (in the vast majority of cases) an early (within 3 h) recognition of an effective agent for a single patient.

scholarly journals Evaluation of BacterioScan 216Dx in Comparison to Urinalysis as a Screening Tool for Diagnosis of Urinary Tract Infections in Children

2019 ◽  
Vol 57 (9) ◽  
Author(s):  
Ferdaus Hassan ◽  
Heather Bushnell ◽  
Connie Taggart ◽  
Caitlin Gibbs ◽  
Steve Hiraki ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Predictive Value ◽  
Screening Tool ◽  
Urine Culture ◽  
Antibiotic Use ◽  
Urine Samples ◽  
Maldi Tof ◽  
Tract Infections

ABSTRACTUrinalysis (UA) has routinely been used as a screening tool prior to urine culture set up. BacterioScan 216Dx is an FDA-cleared semiautomated system to detect bacterial growth in urine. The aim of this study was to evaluate 216Dx in comparison to UA for diagnosis of urinary tract infection (UTI) in children. Clean-catch, unpreserved urine samples from children aged <18 years were tested by 216Dx, and positive urine samples in media were processed for direct bacterial identification by matrix-assisted laser desorption ionization–time of flight (MALDI-TOF) mass spectrometry. Sensitivity and specificity of 216Dx and urinalysis (UA) were determined against urine culture. Of 287 urine samples obtained from children (median age, 108 months), 44.0% and 56.0% were UA positive and negative, respectively, while 216Dx detected 27% and 73% as positive and negative, respectively. Compared to culture, the overall sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 216Dx versus UA were 92.1% versus 97.3%, 82.7% versus 63.8%, 44.8% versus 29.1%, and 98.6% versus 99.3%, respectively. Among 216Dx true-positive (TP) samples (n= 35), 77.0% were successfully identified directly from broth by MALDI-TOF. Among urine samples that were identified as contaminated by culture (n= 127; 44%), the 216Dx detected 93 (73.0%) as negative while UA detected 69 (54.0%) as negative. Although the sensitivities of 216Dx and UA are comparable, the specificity of 216Dx was higher than that of UA. The 216Dx can be used as an alternative/adjunct screening tool to UA to rule out urinary tract infection (UTI) in children. Compared to culture, the faster turnaround time (3 hours) of 216Dx has the potential to reduce unnecessary antibiotic use and improve patient management.

scholarly journals Urinary tract infection and indwelling urinary catheters: prospective study in gynecological surgery with antibiotic prophylaxis

2015 ◽  
Vol 133 (6) ◽  
pp. 517-520 ◽  
Author(s):  
José Carlos Carraro-Eduardo ◽  
Daniela da Silva Alves ◽  
Ingrid Ellis Hinden ◽  
Ivan Penaloza Toledano ◽  
Sarah Gomes Freitas ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Bacterial Growth ◽  
Antibiotic Sensitivity ◽  
Urine Samples ◽  
Gynecological Surgery ◽  
Urinary Catheters ◽  
Sensitivity Testing ◽  
Cell Counts ◽  
Catheter Design ◽  
Tract Infections

ABSTRACT CONTEXT AND OBJECTIVES: Urinary tract infections are the most common cause of hospital-acquired infections, and the use of indwelling urinary catheters is a predisposing factor for their development. The aims of this study were to estimate the frequency of pre and postoperative bacteriuria, identify the microorganisms involved, count the colony-forming units, determine the antibiotic sensitivity profile and compare the results from pre and postoperative urinalyses among women undergoing gynecological surgery with implantation of a urinary catheter. DESIGN AND SETTING: Non-controlled prospective observational single-cohort epidemiological study carried out at a university hospital. METHODS: Urine samples were collected before and 24 hours after catheterization for urinalysis, culturing and antibiotic sensitivity testing. Pre and postoperative urinalyses were compared using Wilcoxon and McNemar non-parametric tests. RESULTS: Fifty-one women participated in the study. Escherichia coligrew in six preoperative samples (11.8%) and Klebsiella pneumoniae in one (1.9%), but bacterial growth did not occur in any postoperative sample. Urinalysis showed lower number of pus cells in the postoperative urine samples (P < 0.05). There were no differences in red blood cell counts or in the nitrite and leukocyte esterase tests, between the samples. CONCLUSION: Bacteriuria was found in 13.7% of the preoperative samples. Gram-negative bacteria sensitive to most antibiotics were identified. In the postoperative samples, no bacterial growth was observed. Urinalysis only showed significant reduction of leukocyturia in the postoperative period.

scholarly journals Prevalence and antibiotic susceptibility pattern of pathogens from urinary tract infections (UTI) in a private diagnostic laboratory in Bangladesh

2020 ◽  
Vol 6 (3) ◽  
pp. 564-569
Author(s):  
Md Habibur Rahman ◽  
Mushtaque Ahmed ◽  
Dayanidhi Sarkar ◽  
Md Asadur Rahman
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Antibiotic Susceptibility ◽  
Antimicrobial Agents ◽  
Urine Samples ◽  
Gram Positive ◽  
Diagnostic Laboratory ◽  
Gram Negative ◽  
Antibiotic Susceptibility Test ◽  
Tract Infections

Urinary tract infection (UTI) is one of the commonest infections encountered by clinicians and despite the widespread availability of antimicrobial agents UTI has become difficult to treat because of appearance pathogens with increasing resistance to antimicrobial agents. The aim and objectives of this study were to determine the pathogens causing UTI and to determine the antibiotic sensitivity status among these isolates in a diagnostic laboratory in Dhaka city. A laboratory based cross sectional survey was conducted in Popular Diagnostic Centre Ltd. Dhanmondi, Dhaka-1205, Bangladesh from July 2016 to December 2016. A total of 553 freshly voided midstream urine samples (10-20 ml) were collected in a wide mouth sterile container from patients and processed in microbiology laboratory to isolate pathogens and antibiotic susceptibility test using standard procedure. Among 553 urine sample, the culture positivity in urine samples was found to be 158 (28.57%) of which 39 (24.70%) were isolated from male patients and 119 (75.30%) from female patients. Escherichia coli (43.67%) were found to be the predominant pathogen followed by Staphylococcus spp. (16.45%), Enterococcus spp. (13.39%), Klebsiella spp. (13.29%), Candida spp. (5.70%), Acinetobacter spp. (4.43%), Psudomonas spp. (3.80%) and Proteus spp. (1.27%). Carbapenem group (Imipenem, Meropenem) were the most effective antibiotic with resistance between 0 and 5.1% of the gram negative isolates and Linezolid and Vancomycin was most effective in gram positive isolates. Nitrofurantoin was most effective both gram negative and gram positive isolates. This study finding showed That Escherichia. coli isolates were the predominant pathogens and showed increasing pattern to the commonly prescribed drugs in private practice that in turn leaves the clinicians with very few alternative options in drug for the treatment of UTIs. Asian J. Med. Biol. Res. September 2020, 6(3): 564-569

scholarly journals Bacteriology and Antibiogram of Urinary Tract Infection Among Female Patients in a Tertiary Health Facility in South Eastern Nigeria

2017 ◽  
Vol 11 (1) ◽  
pp. 292-300 ◽  
Author(s):  
Angus N. Oli ◽  
Vivian B. Akabueze ◽  
Chijioke E. Ezeudu ◽  
George U. Eleje ◽  
Obiora S. Ejiofor ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Susceptibility ◽  
Empirical Treatment ◽  
Urine Samples ◽  
Diffusion Method ◽  
P Value ◽  
Female Patients ◽  
Tract Infections

Background: Urinary Tract Infection (UTI) is a common contagion among men and women with the incidence relatively higher among women due to their differing anatomy. An understanding of the kind of pathogens implicated in urinary tract infections as well as antibiotic susceptibility profiling may help the clinician make rationally correct empirical choice in their treatment. Objective: This study is aimed at determining the type and antibiotic susceptibility pattern of bacterial uropathogens isolated from female patients attending Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka, Nigeria. Method: Two hundred and forty patients with clinically diagnosed UTI and who were on at least 5 days’ antibiotic holiday were recruited into the study. Their demographic characteristics were captured using pre-tested questionnaire. Their clean catch mid-stream urine samples were collected using sterile universal container and sent to the Microbiology Department for processing. Within 30 minutes of samples collection, the specimens were cultured and the isolates were identified, after 24 h of incubation, using standard microbiological techniques. Antibiotic susceptibility tests were done with standard antibiotic discs using the Kirby–bauer disc diffusion method. Results: Out of the 240 urine samples, 89.17% yielded significant bacteriuria. The pathogens implicated were Escherichia coli (28.5%), Staphylococcus aureus (28.0%), Salmonella spp (22.8%) and Pseudomonas aeruginosa (20.5%). HIV status, patients age, pregnancy status and marital status all significantly affected bacteriuria rate (p value < 0.05), while patients’ location (sub-urban/rural dwelling), and level of education did not (p value > 0.05). The pattern of microbial resistance to antibiotics suggests that ceftazidime, fosfomycin and cefoxitin may not be used as first-line agents in the empirical treatment of UTIs rather; levofloxacin, meropenem or aztreonam should be considered. Levofloxacin was significantly effective against all the isolates and may be administered empirically while waiting for the culture result (Mean % susceptibility was 79.85). Conclusion: E. coli and S. aureus were the predominant pathogens in the study and many were resistant to the commonly prescribed antibiotics and so leave the clinicians with only few alternative drugs for UTIs treatment. Routine surveillance and monitoring studies need to be constantly conducted to update clinicians on the prevalent pathogens and the rational and empirical treatment of UTIs. Aggressive and consistent health education using every possible media is also recommended to combat the menace of drug resistance occasioned by inappropriate antibiotic use.

scholarly journals A Rapid, point-of-care antibiotic susceptibility test for urinary tract infections

2020 ◽  
Vol 20 ◽  
pp. S77-S78
Author(s):  
V.M.Ambrosi Grappelli ◽  
S. Pastore ◽  
I. Amato ◽  
C.Fede Spicchiale ◽  
M. Carilli ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antibiotic Susceptibility ◽  
Point Of Care ◽  
Susceptibility Test ◽  
Antibiotic Susceptibility Test ◽  
Tract Infections

scholarly journals Bacteriological Profile of Urinary Tract Infections among Postmenopausal Women Visiting Alka Hospital, Lalitpur, Nepal

2018 ◽  
Vol 2 ◽  
pp. 34-40
Author(s):  
Surendra Prasad Yadav ◽  
Puspa Raj Dahal ◽  
Shiv Nandan Sah ◽  
Vijay Kumar Sharma
Keyword(s):  
Urinary Tract ◽  
Postmenopausal Women ◽  
Antibiotic Susceptibility ◽  
Urine Samples ◽  
Diffusion Method ◽  
Bacterial Isolates ◽  
Gram Positive ◽  
Gram Negative ◽  
Microbiological Methods ◽  
Tract Infections

Urinary tract infection (UTI) is one of the most common diseases encountered worldwide and is a major public health problem in terms of morbidity and financial costs. A cross-sectional study was conducted in Alka Hospital, Lalitpur, Nepal from February to July, 2014. A total of 353 midstream urine samples were collected from postmenopausal women visiting Alka Hospital, Lalitpur, Nepal. The samples were examined by microscopically and culture methods. The isolated organisms were identified by conventional microbiological methods. Antibiotic susceptibility test was performed by modified Kirby-Bauer disc diffusion method according to CLSI (2011) guidelines. Among 353 urine samples processed, 32 % (113) showed significant bacteriuria. Out of 113 bacterial isolates, the prevalence of gram negative bacteria was 97.3% (110) while that of gram positive was 2.7% (3). The most predominating organisms causing UTI were Escherichia coli (84.9%) followed by Klebsiella pneumoniae (5.3%), Enterococcus faecalis (1.7%), Providencia spp. (1.7%), Klebsiella oxytoca (1.7%), Proteus mirabilis (1.7%), Proteus vulgaris (0.9%), Citrobacter freundii (0.9%) and Staphylococcus aureus (0.9%). Antibiotic susceptibility tests of the isolates showed that, most of the gram negative bacterial isolates were sensitive to Piperacillin+Tazobactam followed by Amikacin, Imipenem and Nitrofurantoin, while they were resistant to Amoxicillin. All gram positive isolates were sensitive to Amoxicillin and resistant to Gentamycin. This study showed that higher aged postmenopausal women (>80 years) were at higher risk for UTI than those of lower aged ones (<80 years).

scholarly journals Prevalence and in vitro antibiotic susceptibility pattern of bacterial strains isolated from tribal women suffering from urinary tract infections in District Anuppur, Madhya Pradesh, India

2020 ◽  
Vol 7 (8) ◽  
pp. 3944-3953
Author(s):  
Poonam Sharma ◽  
Aashish Kumar Netam ◽  
Rambir Singh
Keyword(s):  
Public Health ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antibiotic Susceptibility ◽  
Madhya Pradesh ◽  
Urine Samples ◽  
Health Concern ◽  
E Coli ◽  
Tribal Women ◽  
Tract Infections

Introduction: Urinary tract infections (UTIs) are an increasing public health problem caused by a range of uropathogens. UTI is a major health concern among tribal women due to lack of adequate health facilities at regional public health centers and district hospitals. The objective of the study was to investigate the prevalence and antibiotic susceptibility of bacteria isolated from urine samples of tribal women suffering from UTI. Urine samples were collected from 550 tribal women who visited the Outpatient Department (OPD) of the District Hospital of Anuppur, Madhya Pradesh, India. Methods: The samples were cultured on different selective and differential media and identified by colony morphology, Gram staining and biochemical tests. Results: Out of 550 urine samples, 360 (65.45%) were culture-positive and 190 (34.55%) were culture-negative. Klebsiella pneumoniae, Proteus mirabilis, Escherichia coli & Pseudomonas aeruginosa have been identified as major uropathogens. K. pneumoniae is the most prevalent bacteria followed by P. mirabilis, E. coli and P. aeruginosa. The drug sensitivity analysis of bacterial uropathogens was performed against different antibiotics. The antibiotic susceptibility profiling showed that most of the isolates of K. pneumoniae, P. mirabilis and E. coli were resistant against penicillin (86.67-100%) and rifampicin (72.73-97.67%). Conclusions: Gentamycin, kanamycin and streptomycin were the most active antibiotics against the isolates of P. aeruginosa (76, 80 and 76%), P. mirabilis (76.62, 66.23 and 75.32%), K. pneumoniae (55.81, 20.93 and 44.19%) and E. coli (50.48, 37.14 and 62.86%), respectively, and may be the drug of choice for treatment of UTI in this region at present.

scholarly journals FREQUENCY, URINALYSIS AND SUSCEPTIBILITY PROFILE OF PATHOGENS CAUSING URINARY TRACT INFECTIONS IN ENUGU STATE, SOUTHEAST NIGERIA

2014 ◽  
Vol 56 (1) ◽  
pp. 55-59 ◽  
Author(s):  
Uju M.E. Dibua ◽  
Ifeoma S. Onyemerela ◽  
Emeka I. Nweze
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antibiotic Susceptibility ◽  
Urine Samples ◽  
Biochemical Tests ◽  
Culture Methods ◽  
E Coli ◽  
Standard Procedures ◽  
Enugu State ◽  
Tract Infections

Objective: This study was designed to determine the frequency and causative agent(s) of urinary tract infections (UTIs) in individuals with symptoms of urinary tract infections in Enugu State of Southeast Nigeria, and to determine the antibiotic susceptibility pattern of microbial agents isolated from urine culture. Methods: The study involved 211 individuals (149 females and 62 males) clinically suspected for UTI. Urine samples were collected by the mid-stream ‘clean catch' method and tested using standard procedures. Antibiotic susceptibility of the isolated pathogens was tested using the Kirby-Bauer technique according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Microscopy of centrifuged urine samples showed 16 patients had pyuria while 54 had pus cells. Calcium oxalate crystals were found in 14 samples. Urinalysis performed with urine samples showed 17 had protein; seven were nitrite positive and three had moderate to high glucose concentration. Fifty-four urine samples (36.2%) from females and 12 (19.4%) from males showed significant growth upon culture. Gram stain and biochemical tests identified nine different organisms with Escherichia coli as the most common isolated species. Forty three randomly selected strains were further tested for their susceptibility against a panel of antibiotics. Thirty isolates (81.08%) were resistant to four or more antibiotics with the highest resistance shown by E. coli (76.67%). All the Gram- negative isolates were resistant to Ampicilox, Cefuroxime and Amoxicillin. Conclusion: Urinary tract infections were found more in females in the area under study. As found in other studies, E. coli was the most predominant isolate, although other organisms seem to be on the increase.

scholarly journals Frequency and antibiotic susceptibility pattern of uropathogenic agents of urinary tract infections among asymptomatic diabetic patients in Okada community, southern Nigeria

2019 ◽  
Vol 34 (1) ◽  
Author(s):  
Ruqayyah B. Adegbite ◽  
Hammed O. Ojokuku ◽  
Kamoru A. Adedokun ◽  
Musiliu A. Oyenike ◽  
Ramat T. Kamorudeen
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Samples ◽  
University Teaching ◽  
Medical Laboratory ◽  
Renal Diseases ◽  
Diabetic Patients ◽  
Sensitivity Testing ◽  
Southern Nigeria ◽  
Tract Infections

Massive evidence showed that patients with diabetes have a high risk of urinary tract infections. We studied the frequency of potential urinary uropathogens among diabetic patients and identified their antimicrobial susceptibility patterns. This was a prospective hospital-based study conducted at the Department of Medical Laboratory Science, Igbinedion University Teaching Hospital, Southern Nigeria, between January 2014 and May, 2014. We included 240 previously confirmed diabetic patients (women, n=70 and men, n=170) who were regularly followed up without prior treatment with any antimicrobial therapy and within the age range of 26-75 years. Patient personal history data and midstream urine samples were collected. Urine samples were processed in the laboratory following a Standard Laboratory Protocol. Escherichia coli, Staphylococcus aureus, Klebsiella spp. and Candida spp. were isolated in this study. A significant bacteriuria count was estimated in 12.5% of the sampled population, while 17.1 and 10.6% were estimated in females and males, respectively. Similarly, candiduria was found in female, male and total sample in 12.9%, 2.9%, and 5.8%, in that order. According to antimicrobial sensitivity testing, the Gram-negative bacilli isolated were highly sensitive to nitrofurantoin followed by ofloxacin, gentamycin and least sensitive to cefuroxime. Estimation of potential uropathogens among asymptomatic diabetic populations may avert possible urinary tract infections and their possible complications ultimately and thus prevent possible advanced renal diseases.

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