Screening of presumptive urinary tract infections by the automated urine sediment analyser sediMAX

2015 ◽  
Vol 53 (s2) ◽  
Author(s):  
Andrea Tessari ◽  
Nicoletta Osti ◽  
Marino Scarin
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Predictive Value ◽  
Urine Culture ◽  
False Negative ◽  
False Negative Rate ◽  
Urine Samples ◽  
Indwelling Catheter ◽  
Urine Sediment ◽  
Tract Infections

AbstractUrinary tract infections (UTI) are among the most common bacterial infections and urine samples represent a large proportion of the specimens processed in clinical microbiology laboratories, up to 80% of which, however, yield negative results. Automated microscopy is widely used for urine sediment analysis and has recently been evaluated in a few studies for bacteriological screening of urine samples, achieving high levels of performance.We present a study in which urine samples from both inpatients and outpatients, with either clean-catch or indwelling catheter urine samples, were screened for UTI by urine culture, as the reference method, and the automated urine analyser sediMAX, for the detection of bacteria, leukocytes and yeasts.In total, 3443 urine samples were evaluated. When a single algorithm was adopted for sediMAX to screen the total patient population, 96.4% sensitivity, 75.4% specificity, 57.8% positive predictive value, and 98.4% negative predictive value were found. However, for male outpatients and all patients with indwelling catheter other algorithms were necessary to improve performances. Altogether, with sediMAX false negative rate was 2.4% and false positive rate was 27.6%. In addition, 54% of the investigated samples could have avoided urine culture.After the identification of specific algorithms for different patient subgroups, the automated urine analyser sediMAX can be reliably employed in the screening of UTI.

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 infections in culled sows from Greek herds: prevalence and associations between findings of histopathology, bacteriology and urinalysis

2020 ◽  
Author(s):  
Mihaela Cernat ◽  
Vasilis Skampardonis ◽  
Georgios A. Papadopoulos ◽  
Fotios Kroustallas ◽  
Sofia Chalvatzi ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Chronic Inflammation ◽  
Urinary Tract Infections ◽  
Urine Samples ◽  
Urine Ph ◽  
Urine Sediment ◽  
Positive Urine ◽  
Tract Infections ◽  
Staphylococcus Spp ◽  
On Farm

Abstract Background Urinary tract infections (UTI) of sows which include cystitis, which may progress to ureteritis and pyelonephritis affect their productivity, longevity and welfare. In this study we determined the prevalence of UTI by histopathology and bacteriology and investigated possible associations between histologically confirmed cystitis and the results of urinalysis and urine cultures in culled sows from three Greek farrow-to-finish herds. Materials and methods Routinely culled sows were included in the study. Their urinary bladders were collected from abattoirs and examined histopathologically. Furthermore, urinalysis and urine cultures were performed on urine samples aseptically collected from the bladders. Results Histologically confirmed cystitis was evident in 85/185 (45.94%) culled sows. Among those, 44 (51.76%) suffered from acute and 41 (48.24%) from chronic inflammation. The majority of the positive urine cultures were due to colonization of the urinary tract with E.coli, which was responsible for 55.81% of the total cases, followed by Staphylococcus spp. which caused 18.60% of the infections detected. Evidence of cystitis was associated with bacteriuria and sows with bacteriuria were 2.30 (p = 0.03, 95% CI: 1.10–4.83) times more likely to have histologically confirmed cystitis compared to sows with negative urine cultures. Bacteriuria was associated with proteinuria (p < 0.01), urine pH (p < 0.01) and presence of sediment (p < 0.01) in urine. Sows with proteinuria had 9.72 (2.63–35.88) times higher odds of bacteriuria than those without. Histologically defined cystitis was associated with proteinuria (p < 0.01) and increased urine pH (p < 0.01). Sows with proteinuria were 5.18 times (2.03–13.2) more likely to have histological lesions consistent with cystitis, than those without. Conclusions In the studied herds, UTI affected almost one out of two culled sows. Bacteriuria, which was more common among sows with UTI than those without, was mainly ascribed to members of the intestinal and environmental microbiota. Proteinuria and the existence of urine sediment which were associated with UTI may be proposed as likely on-farm predictors of UTI in live sows.

scholarly journals Retrospective Evaluation of the Performance of Leukocyte Parameter of the Automated Urine Analyzer and Its Concordance with Urine Culture

2021 ◽  
Author(s):  
Murat Koser ◽  
Nilgün Işıksaçan ◽  
Ramazan Korkusuz ◽  
Gülçin Şahingöz Erdal ◽  
Pınar Atar ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Chemical Analysis ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Urine Samples ◽  
Analytical Sensitivity ◽  
Predictive Values ◽  
Leukocyte Counts ◽  
Tract Infections ◽  
Sensitivity Specificity

Objective: Complete urinalysis (CUA) is one of the indispensable screening tests of clinical laboratories. The compatibility of this test with urine culture is of indispensable importance in the diagnosis and treatment of urinary tract infections. We aimed to evaluate the suitability of the leukocyte parameter measured in the microscopic units of the fully automated urine analyzers which replace traditional methods, by grouping them according to the results of chemical analysis. Materials and Methods: Leukocyte counts in the reported CUA results of 4685 outpatients and the results of 113 urine cultures studied on the same day were analyzed. Noncentrifugated urine samples were included in the analysis. Cells were digitally imaged by flow microscopy. Chemical analyzes were performed using dual wavelength reflectance method. Urine samples were evaluated after 24 hours of incubation. Results: High power field (HPF) values were recorded by grouping the leukocyte counts as negative, trace, 1+, 2+ and 3+. The arithmetic means of HPF values of the groups were calculated as 1.2, 2.1, 5.0, 11 and 208 white blood cell (WBCs/HPF). Bacterial growth was detected in 19 of 113 patients and no reproduction was observed in the remaining 94 cases. When results of microscopic examinations and chemical analysis were compared with the culture results, the analytical sensitivity, specificity, positive, and negative predictive values for microscopic urinalysis were 25%, 86%, 61.3%, and 58.3%, respectively. While, the analytical sensitivity, specificity, positive, and negative predictive values for chemical analysis of urine were 25.8%, 87.7%, 69.7%, and 51.4%, respectively. Conclusion: The workload of medical laboratories is increasing, and the use of urine autoanalyzers may be preferred for busy laboratories. In the diagnosis and follow-up of urinary tract infections, complete urinalysis by autoanalysers in which the harmony of their microscopy and chemical units are closely monitored, may reduce the need for unnecessary requests for urine culture, but it cannot replace urine culture.

Abstract W P344: Being the Change You Wish to See: Reducing the Incidence of False-Positive Catheter-Associated Urinary Tract Infections in a Neuroscience Population

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Sarah Lester ◽  
Pamela Branson
Keyword(s):  
Intensive Care ◽  
Urinary Tract ◽  
Intensive Care Units ◽  
Urinary Tract Infections ◽  
False Positive ◽  
Biofilm Formation ◽  
Urine Culture ◽  
Bacterial Biofilm ◽  
Indwelling Catheter ◽  
Tract Infections

Background and Purpose: The formation of a bacterial biofilm on an indwelling urinary catheter is considered to be a leading cause for diagnosed urinary tract infections in the intensive care setting (Djeribi, Bouchloukh, Jouenne, & Menaa, 2012). Bacterial biofilms (colonization) are thought to develop between one to five days (Saint & Chenoweth, 2003). Neuroscience patients are of particular interest when examining biofilm formation, as their underlying disease processes pose unique challenges to decreasing indwelling catheter device days, including neurogenic bladder, need for euvolemic fluid volume states, et cetera. The purpose of this quality improvement initiative was targeted at reducing the number of diagnosed false-positive CAUTI. Methods: For a period of February 2014- July 2014, nurses in two neurosciences intensive care units at a large academic center piloted an intervention targeted at reducing the number of diagnosed false-positive CAUTI, thought to occur as a result of catheter colonization or biofilm formation. For the intervention, patients who received an order for a urine culture who had an indwelling catheter for equal to or greater than five days had their indwelling catheter changed. Urine cultures were subsequently obtained from the new indwelling catheter. Results: Data for the months ( February 2014-July 2014) included a total of 87 patients from the neurosciences intensive care units who met the criteria for an indwelling catheter change, in the event that they had a urine culture ordered on or after device day five. Twenty six patients had their indwelling catheter changed prior to urine specimens being obtained. Five of the twenty six obtained from the new indwelling catheters demonstrated growth at the time the reports were finalized. Compared to previous CAUTI rates for the same time period in 2013 we have reduced the absolute numbers from 30 to 13. Conclusions: The organization’s infection control board reviewed the data and permission was granted to extend the pilot to all adult ICU. The preliminary data does suggest bacterial biofilm may contribute to the rate of CAUTI in the neuroscience population.

URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
University Hospital ◽  
E Coli ◽  
Positive Urine ◽  
Tract Infections

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

Effect of an external urinary collection device for women on institutional catheter utilization and catheter-associated urinary tract infections

2020 ◽  
pp. 1-3
Author(s):  
Lindsey Rearigh ◽  
Gayle Gillett ◽  
Adrienne Sy ◽  
Terry Micheels ◽  
Luana Evans ◽  
...  
Keyword(s):  
Experimental Study ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Indwelling Catheter ◽  
Collection Device ◽  
Quasi Experimental ◽  
Tract Infections

Abstract External urinary collection devices (EUCDs) may reduce indwelling catheter usage and catheter-associated urinary tract infections (CAUTIs). In this retrospective quasi-experimental study, we demonstrated that EUCD implementation in women was associated with significantly decreased indwelling catheter usage and a trend (P = .10) toward decreased CAUTI per 1,000 patient days.

scholarly journals Exploring the possibilities of infrared spectroscopy for urine sediment examination and detection of pathogenic bacteria in urinary tract infections

2020 ◽  
Vol 58 (10) ◽  
pp. 1759-1767
Author(s):  
Mieke Steenbeke ◽  
Sander De Bruyne ◽  
Jerina Boelens ◽  
Matthijs Oyaert ◽  
Griet Glorieux ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Pathogenic Bacteria ◽  
Agar Plate ◽  
Principal Component ◽  
Blood Agar Plate ◽  
Urine Sediment ◽  
Flight Mass Spectrometry ◽  
Tract Infections

AbstractObjectivesIn this study, the possibilities of Fourier-transformed infrared spectroscopy (FTIR) for analysis of urine sediments and for detection of bacteria causing urinary tract infections (UTIs) were investigated.MethodsDried urine specimens of control subjects and patients presenting with various nephrological and urological conditions were analysed using mid-infrared spectroscopy (4,000–400 cm−1). Urine samples from patients with a UTI were inoculated on a blood agar plate. After drying of the pure bacterial colonies, FTIR was applied and compared with the results obtained by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Chemometric data analysis was used to classify the different species.ResultsDue to the typical molecular assignments of lipids, proteins, nucleic acids and carbohydrates, FTIR was able to identify bacteria and showed promising results in the detection of proteins, lipids, white and red blood cells, as well as in the identification of crystals. Principal component analysis (PCA) allowed to differentiate between Gram-negative and Gram-positive species and soft independent modelling of class analogy (SIMCA) revealed promising classification ratios between the different pathogens.ConclusionsFTIR can be considered as a supplementary method for urine sediment examination and for detection of pathogenic bacteria in UTI.

Urinary Tract Infections in Febrile Infants Younger Than 8 Weeks of Age

PEDIATRICS ◽  
1990 ◽  
Vol 86 (3) ◽  
pp. 363-367 ◽  
Author(s):  
Ellen F. Crain ◽  
Jeffrey C. Gershel
Keyword(s):  
Emergency Department ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
White Blood Cells ◽  
Laboratory Data ◽  
Pediatric Emergency ◽  
Urine Specimen ◽  
High Power Field ◽  
Tract Infections

In this prospective study of 442 infants younger than 8 weeks of age who attended a pediatric emergency department with temperature ≥100.6°F (38.1° C), urinary tract infections (UTIs) were found in 33 patients (7.5%), 2 of whom were bacteremic. Clinical and laboratory data were not helpful for identifying UTIs. Of the 33 patients with UTIs, 32 had urinalyses recorded; 16 were suggestive of a UTI (more than five white blood cells per high-power field or any bacteria present). Of the 16 infants with apparently normal urinalysis results, three had an emergency department diagnosis suggesting an alternative bacterial focus of infection. If the physician had decided on the basis of apparently normal urinalysis results to forgo obtaining a urine culture, more than half of the UTIs would have been missed. Bag-collected specimens were significantly more likely to yield indeterminate urine culture results than either catheter or suprapublic specimens. In addition, uncircumcised males were significantly more likely to have a UTI than circumcised boys. These results suggest that a suprapubic or catheter-obtained urine specimen for culture is a necessary part of the evaluation of all febrile infants younger than 8 weeks of age, regardless of the urinalysis findings or another focus of presumed bacterial infection.

A New Screening Approach For Fast And Accurate Prediction Of Positive And Negative Urine Cultures By SediMAX Compared With The Standard Urine Culture

2021 ◽  
Vol 1 (1) ◽  
pp. 46-55
Author(s):  
Massimo Pieri ◽  
Flaminia Tomassetti ◽  
Paola Cerini ◽  
Roberta Felicetti ◽  
Lucia Ceccaroni ◽  
...  
Keyword(s):  
Blood Cell ◽  
Bacterial Infections ◽  
Urine Culture ◽  
Screening Method ◽  
Significant Proportion ◽  
Bacterial Count ◽  
Urine Samples ◽  
Screening Methods ◽  
Urine Sediment ◽  
Tract Infections

Urinary tract infections (UTI) are the most frequent bacterial infections, and the detection of infection in urine samples is expensive and time-consuming. Also, in laboratories a significant proportion of samples processed yield negative results. For this, screening methods represent an important improvement towards the final UTI diagnosis. SediMAX is an automated microscopy, easier to use in laboratories due to its basic procedure and it is widely used for urine sediment analysis. In our study, we evaluated the performance of SediMAX, applying some screening parameters, compared with the gold standard methods, urine culture, to identify all the positive cases for UTI. We analysed 1185 urine samples from our daily laboratory routine. The basis of our screening model was to establish a cut-off for bacterial count (BACT), as 300 bacteria/µL in order to avoid missing positive cases. However, the sensitivity and the specificity achieved were not enough to identify all UTI infection in urine samples. So, in addition to BACT we have considered other parameters, such as White Blood Cell (WBC), Red Blood Cell (RBC), Yeasts (YEST), Age and Nitrates (NIT). The second screening method reached a sensitivity of 100%, that could be reliably employed in detect of UTIs.

Culturing practices and the care of the urinary catheter in reducing NHSN-defined catheter-associated urinary tract infections: The tale of two teaching hospitals

2018 ◽  
Vol 39 (12) ◽  
pp. 1494-1496 ◽  
Author(s):  
Ana Cecilia Bardossy ◽  
Takiah Williams ◽  
Karen Jones ◽  
Susan Szpunar ◽  
Marcus Zervos ◽  
...  
Keyword(s):  
Intensive Care ◽  
Urinary Tract ◽  
Intensive Care Units ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Urinary Catheter ◽  
Teaching Hospitals ◽  
Positive Urine ◽  
Tract Infections ◽  
Catheter Care

AbstractWe compared interventions to improve urinary catheter care and urine culturing in adult intensive care units of 2 teaching hospitals. Compared to hospital A, hospital B had lower catheter utilization, more compliance with appropriate indications and maintenance, but higher urine culture use and more positive urine cultures per 1,000 patient days.

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