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 ◽  
...  

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.

2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection


2021 ◽  
Vol 8 (10) ◽  
pp. 522-526
Author(s):  
Bhavani Shankar Rokkam ◽  
Chowdary Babu Menni ◽  
Ramu Pedada ◽  
Deepak Kumar Alikana

BACKGROUND Urinary tract infections (UTI) constitute a common cause of morbidity in infants and children. When associated with abnormalities of urinary tract, they may lead to long-term complications including renal scarring, loss of function and hypertension. Most urinary tract infections remain undiagnosed if investigations are not routinely performed to detect them. Prompt detection and treatment of urinary tract infections and any complicating factors are important. The objective of the study is to know the clinical, epidemiological and bacteriological profile (i.e. clinical signs and symptoms, age, sex, family history, associated urinary tract abnormalities, & causative organisms) of urinary tract infections in febrile children with culture positive urinary tract infection. METHODS This descriptive, cross sectional observational study was conducted at outpatient clinics of our “child health clinics” between May 2016 and April 2017 (one year). All children aged 0 to 12 years with culture positive urinary tract infections were included in this study to evaluate the clinical, epidemiological and bacteriological profile. RESULTS A total of 69 children with culture positive urinary tract infections were included in this study. Out of 69 children included in this study, 36 (52.2 %) were females and 33 (47.8 %) were males. Overall female preponderance was seen and the M: F ratio was 0.9:1. But during first year of life in our study group we had more boys (10, 14.49 %) affected with urinary tract infection than girls. 49.3 % of urinary tract infections in the present study belonged to lower socio-economic status. Most common organism causing urinary tract infection in our group was E. coli (56.5 %). Fever (100 %), anorexia or refusal of feeds (52.2 %), dysuria (46.4 %), vomiting (46.4 %) and abdominal pain (39.1 %) were the predominant clinical manifestations observed in our study. CONCLUSIONS Urinary tract infection is a common medical problem in children and it should be considered as a potential cause of fever in children. As febrile children with urinary tract infection usually present with non-specific signs and symptoms, urine culture should be considered as a part of diagnostic evaluation. KEYWORDS Urinary Tract Infections (UTI), Febrile Children, Bacteriological Profile, Urine Culture


2017 ◽  
Vol 2 (1) ◽  
pp. 134-137 ◽  
Author(s):  
Binita Pradhan ◽  
SB Pradhan

IntroductionIn developing countries, urinary tract infections (UTIs) are one of the most commonly diagnosed diseases among the patient seeking medical service and being treated with empirical antibiotics which causes resistance.ObjectiveTo find out the prevalence of urinary tract infection and sensitivity pattern of antibiotics among bacterial pathogens isolated in patients attending Kathmandu Medical College Teaching Hospital, Duwakot.MethodologyAll the patients with the clinical suspicion of UTI were sent for urine culture. Prevalence of UTI and urinary pathogens isolated with antimicrobial profile was correlated.ResultA total number of 1735 clinically suspected as UTI cases were sent for urine culture sensitivity. Total culture positive were 239 (13.8%). The majority of isolates were from female patients comprising 180 (75%). The most common pathogenic microorganism isolated was E.coli (79.1%). Second most common organism was Klebsiella (11.7%) followed by Citrobacter (3.34%) and Proteus (2.92%). The isolated microorganism showed maximum number of sensitivity with the antibiotics Ofloxacin and Ciprofloxacin. The isolated microorganism demonstrated resistance with Nalidixic Acid and Co-Trimoxazole. ConclusionUrinary tract infection is a commonly encountered case in general practice. Females are commonly affected than men. The microbiological profile and the antibiotic sensitivity pattern while initiating empirical treatment must be taken into account while planning for the management. Regular supervision of the sensitivity pattern of pathogenic microorganism is mandatory for effective treatment.Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 134-137


Open Medicine ◽  
2013 ◽  
Vol 8 (5) ◽  
pp. 597-599 ◽  
Author(s):  
Tsuneaki Kenzaka ◽  
Ayako Kumabe ◽  
Yuka Urushibara ◽  
Kensuke Minami ◽  
Takeshi Ishida

AbstractA 93-year-old woman with neurogenic bladder was admitted to our hospital because of impaired consciousness. Her urine culture revealed urease-test-positive Corynebacterium urealyticum. She was diagnosed with hyperammonemia due to an obstructive urinary tract infection that was caused by urease-producing bacteria. The patient showed rapid improvement of impaired consciousness and hyperammonemia after urine analysis. It is necessary to consider obstructive urinary tract infection as a differential diagnosis of hyperammonemia, which commonly occurs in urinary tract infections owing to the presence of urease-producing bacteria. Relief from obstruction is the most important treatment for hyperammonemia caused by this mechanism.


2020 ◽  
Author(s):  
Mohammad Hasan Namaei ◽  
Hengameh Hamzei ◽  
Marzie Moghanni ◽  
Azadeh Ebrahimzadeh

Abstract Background: Urinary Tract Infection (UTI) is the most common bacterial infection in the world. E. coli is the predominant Pathogen. This study evaluates the prevalence of ESBL in E. colis isolated from patients with urinary tract infections with phenotypic and genotypic methods.Methods: This descriptive-analytical study was done on 155 isolates of E. coli isolated from patients with urinary tract infection who had received the study consent. After accurate identification of E. coli strains. ESBL production for Escherichia coli isolates which are resistant to ceftriaxone or ceftazidime was evaluated by CDT method. TEM, SHV and CTX-M genes were identified by PCR.Results: The results showed that 30 strains from 155 strains of E. coli had ESBL. Strains of ESBL producer were more in males was lower in educated persons. 38.9% of ESBL producer had antibiotic use, 29.9% -producing Escherichia hospitalization and 31.6% uti history. The highest level of drug allergy in the ESBL was related to nitrofurantoin, and the highest resistance was related to cefazolin, co-trimoxazole. The CTX-M and the CTX-M15 gene were found in 92.7% and 57.1% of cases, respectively; also the SHV and TEM genes were not found in any of ESBL-producing Escherichia coli strains. Most therapeutic response in patients was related to cefexime, ciprofloxacin and nitrofurantoin 27.4%, 26% 21.9%, respectively.Conclusion: This study showed that the history of antibiotic use, hospitalization, uti related to increase of ESBL-producing in E. coli isolates., the CTMX-M gene is the most common gene in ESBL-producing E. coli strains.


2013 ◽  
Vol 53 (2) ◽  
pp. 70
Author(s):  
Meirina Daulay ◽  
Rosmayanti Siregar ◽  
Oke Rina Ramayani ◽  
Supriatmo Supriatmo ◽  
Rafita Ramayati ◽  
...  

Background Urinary tract infection (UTI) is the most commoncause of fever in children. Less frequent disposable diaper changingis thought to be a cause ofUTI in children. While wearing a diapei;the perinea! area becomes damp with urine allowing bacteria tomigrate from the anus to the external urethral orifice.Objective To assess for an association between the frequencyof disposable diaper changing and urinary tract infections inchildren.Methods This cross-sectional study was conducted in thechildren's outpatient clinic of Haji Adam Malik Hospital fromApril to June 2010. Urine culture was performed in children withsuspected UTI who wore disposable diapers every day. Subjects'ages ranged from 2 months to 2 years 6 months, with samplesmatched and collected by consecutive sampling. Diagnosis ofUTIwas based on urine cultures with bacterial count 2:: 105/mL. Eightychildren were followed in this study and divided into two groups:positive (n=40) and negative (n=40) urine cultures. Chi squaretest was use d to analyze the association between the frequency ofdaily disposable diapers changing during a one week period andthe urine culture results.Results The frequency of daily disposable diapers changing in80 subjects was as follows: < 4 times (22.5%), 4-5 times (40%),and 2::6 times (37.5%) . The frequency of daily disposable diaperchanging in children with positive urine culture was as fo llows:< 4 times (1 8 out of 40), 4-5 times (22 out of 40), and 2::6 times(O out of 40); (P < 0.0001). The most common bacterial speciesfound in urine cultures was Escherichia coli.Conclusion Lower frequency of daily disposable diaper changingis significantly associated with higher UTI incidence in children.


Author(s):  
Anthony Okhonlaye Ojokoh ◽  
Olumide Mogaji ◽  
Bartholomew Saanu Adeleke

Aim: This study is designed to isolate and identify the microorganisms associated with urinary tract infection in infected patients, determine the antimicrobial resistance pattern on the microbial isolates and the antimicrobial efficacy of solvents leaf extract of Chromolaena odorata on the resistant isolates. Methodology: Six hundred (600) mid-stream urine samples were collected from infected patients in some selected hospitals in Ondo State. The phytochemical screening of the plant was determined. The antibiotics sensitivity and antimicrobial activity of the plant extract was determined using plate assay and agar well diffusion methods. Results: Out of 600 urine samples analyzed, 472 (78.68%) showed significant growth of uropathogens comprising 197 (32.80%) male and 275 (45.83%) female. The isolated microorganisms comprise 5 Gram-positive bacteria (GPB), 9 Gram-negative bacteria (GNB) and 4 Candida sp. GNB account for 284(58.79%), GPB 158(32.71%) and Candida sp 41(8.48%). Escherichia coli showed high prevalence 90(18.63%) while Klebsiella ozaenae showed the least 11(2.27%). The phytochemical constituents of C. odorata extracts contained tannins, flavonoids, saponins, steroids and terpernoids and bacterial isolates showed resistant to all the antibiotics. Pseudomonas mendocina and P. putida showed the least resistant to C. odorata extracts. The MIC of the leaf extracts ranged from 5.0 mg/ml to 50.0 mg/ml.  The methanol extract had the highest antimicrobial activity than n-hexane and chloroform extracts on the uropathogens. Conclusion: The high therapeutic potentials of C. odorata extract against the uropathogens could be used as alternative phytotherapy in herbal medicine to the commercial antibiotics in the treatment of urinary tract infections.


2021 ◽  
Vol 9 (2) ◽  
pp. 131-137
Author(s):  
Putra Rahmadea Utami

 Urinary tract infection (UTI) is the second largest infection after respiratory infection and can cause sepsis. Urinary tract infections occur due to the entry of microorganisms in the urinary tract. The urinary tract that is usually infected is the urethra (urethritis), bladder (cystisis), ureter (ureteristis), kidney tissue (pyelonephritis). This study aims to determine the sensitivity and specificity of the diagnostic test of nitrite examination with urine culture in suspected urinary tract infections. The method of this study is a descriptive-analytical study with a cross-sectional retrospective approach, conducted in the STIKes field laboratory with the population studied in this study were all patients diagnosed with urinary tract infection with a sample size of 50 samples. The results of this study showed positive nitrite results as many as 17 people, 34% percentage, and negative nitrite results as many as 33 people with a percentage of 66% and on urine culture examination obtained positive results as many as 17 people with a percentage of 34%, which results in growth of bacterial colonies on cultures> 100,000 CFU / mL and negative results of 33 people with a percentage of 66%. Sensitivity Results 82%, Specificity 90.9%. The conclusion of this study is the value of sensitivity, high specificity so that the nitrite test with urine culture can be applied to help diagnose UTI.


Author(s):  
Yeva Rosana ◽  
Dwiana Ocviyanti ◽  
Rahmah Amran

Abstract Objectives:To investigate the role of microscopic examination of urine sample in supporting early diagnosis of asymptomatic urinary tract infection (UTI) in pregnant women. To compare correspondence between microscopic examination and urine culture result as a gold standard diagnostic modality to support the diagnosis of UTIs and as an evidence-based to start empirical therapy. Methods: Microscopic analysis was conducted in 74 centrifuged and non-centrifuged urine samples from 317 pregnant who came to six healthcare centres in Jakarta, which showed a positive result of nitrite examination.  The results of the microscopic examination of bacteriuria and leukocyturia were compared with a urine culture. Results: Sensitivity of centrifuged bacteriuria was the highest among the other microscopic parameters, which was 74% with the p-value of 0.009. Combination of bacteriuria and leukocyturia≥3/HPF dan≥5/HPF have increased the specificity with the value of 91.5% and 93.6% in non-centrifuged urine. Conclusion: This result showed that the best method of microscopic examination for early diagnosis of asymptomatic urinary tract infection in pregnant women is the detection of bacteriuria in centrifuged urine. Combination of bacteriuriaandleukocyturiatest, as well as leukocyturia≥3/HPF and≥5/HPF,  can be used to rule out the diagnosis of UTI at an early stage. Keywords: asymptomatic urinary tract infection, bacteriuria, leukocyturia,microscopic examination, urine culture.   Abstrak Tujuan: Mengetahui peran pemeriksaan mikroskopis sampel urin dalam mendukung diagnosis dini infeksi saluran kemih asimptomatik (ISK) pada perempuan hamil. Membandingkan kesesuaian antara pemeriksaan mikroskopis dan hasil kultur urin sebagai modalitas diagnostik standar emas untuk mendukung diagnosis ISK dan sebagai dasar bukti untuk memulai terapi empiris. Metode: Penelitian uji mikroskopik dilakukan pada 74 sampel urin disentrifugasi dan tidak sentrifugasi, dari 317 sampel urin perempuan hamil yang berobat ke-enam puskesmas di Jakarta dengan uji nitritpositif. Hasil uji mikroskopik bakteri uria dan leukosit uria dibandingkan dengan hasil kultururin. Hasil: Sensitivitas bakteriuria yang disentrifugasi menunjukan hasil yang paling baik dibandingkan dengan parameter uji mikroskopik lain, yaitu 74% dengan nilai p yang bermakna sebesar 0,009.  Kombinasi bakteri uria dan leukosituria ≥3/LPB dan ≥5/LPB dapat meningkatkan spesifisitas uji dengan nilai 91,5% dan 93,6% pada urin yang  tidak disentrifugasi. Kesimpulan: Hasil menunjukkan bahwa bakteri uria pada urin yang disentrifugasi, merupakan metode yang paling baik untuk membantu diagnosis dini ISK tidak bergejala pada perempuan hamil. Uji kombinasi bakteri uria dan leukosituria, serta uji leukosituria ≥3/LPB dan ≥5/LPB dapat dimanfaatkan untuk membantu secara dini menyingkirkan orang yang tidak mengalami  ISK. Kata kunci: bakteriuria, infeksi saluran kemih tidak bergejala, kultur urin,leukosituria, uji mikroskopik


2017 ◽  
Vol 11 (1) ◽  
pp. 292-300 ◽  
Author(s):  
Angus N. Oli ◽  
Vivian B. Akabueze ◽  
Chijioke E. Ezeudu ◽  
George U. Eleje ◽  
Obiora S. Ejiofor ◽  
...  

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.


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