scholarly journals Point-of-Care Urine Gram Stain for Managing Febrile Urinary Tract Infection in Adults

2022 ◽  
Author(s):  
Tomohiro Taniguchi ◽  
Sanefumi Tsuha ◽  
Soichi Shiiki ◽  
Masashi Narita
Keyword(s):  
Urinary Tract ◽  
World Wide ◽  
Point Of Care ◽  
Gram Stain ◽  
Febrile Urinary Tract Infection ◽  
Common Cause ◽  
High Effectiveness ◽  
The World ◽  
Febrile Urinary Tract Infections ◽  
Tract Infections

Abstract Background Febrile urinary tract infections (fUTIs), which include pyelonephritis, prostatitis, and urosepsis, are the most common cause of sepsis. However, the treatment has become more complex because of the world-wide increase in antimicrobial resistance (AMR). The objective of this study was to clarify whether point-of-care Gram stain (PCGS) of urine contributed to fUTI diagnosis and treatment in adults. Methods This hospital-based observational study was undertaken between January 2013 and March 2015 in Okinawa, Japan. All enrolled patients were adults who had been admitted to the Division of Infectious Diseases with suspected fUTI. The usefulness of PCGS results were compared for urinalysis (U/A) and urine cultures (U/Cs). The targeted therapy type and its effectiveness based on PCGS were analyzed, and each was investigated in two groups: the uncomplicated pyelonephritis group and the complicated pyelonephritis/prostatitis group. Results Two hundred sixty-six patients were enrolled. The results of PCGS were closely correlated with those of U/A for pyuria and bacteriuria, and moderately correlated with the results of U/C for bacterial types. In the uncomplicated group, narrow-spectrum antimicrobials such as cefotiam were initially selected in 97.9% (47/48) of patients, and their effectiveness was 97.9% (47/48). In the complicated group, the effectiveness was 84.2% (186/221) (p=0.009) despite frequent AMRs (14.7%; 32/218) and low use of broad-spectrum antimicrobials such as carbapenems (7.7%; 17/221). Conclusion Urine PCGS led to a more precise fUTI diagnosis and prompted clinicians to select narrower-spectrum antibiotics with high effectiveness.

scholarly journals Comparing the Performance of the New Fully Automated Urine Particle Analyzer UF-5000 with UF-1000i and Gram Stain in Predicting Bacteria Growth Patterns in Women with Uncomplicated Urinary Tract Infections

2020 ◽  
Author(s):  
Stephen Shei-Dei Yang ◽  
Chun-Chun yang ◽  
Yi-Shen Chen ◽  
Shangjen chang
Keyword(s):  
Urinary Tract ◽  
Urine Analysis ◽  
Growth Patterns ◽  
Gram Stain ◽  
Gram Positive ◽  
Gram Negative ◽  
Bacterial Patterns ◽  
Tract Infections ◽  
Sensitivity Specificity ◽  
Gram Positive Cocci

Abstract BackgroudTo compare the performance of the new flow cytometer UF-5000 with UF-1000i (Sysmex, Kobe, Japan) and Gram stain in predicting the bacterial patterns in urine samples MethodsWomen with symptoms suggestive of urinary tract infection were enrolled. Mid-stream urine sample was collected for gram staining, urine analysis and urine culture. Bacterial patterns were classified though UF1000i (none, cocci bacteria or rods/mixed growth), UF-5000 (none, cocci, rods or mixed growth) and Gram stain. Results Among the 102 samples, there were 10 gram-positive cocci, 2 gram-positive bacilli, 66 gram-negative rods, and 24 mixed growth. The sensitivity/specificity of the UF-1000i was 81.8/91.1% for gram-negative rods and 23.5/96.9% for cocci/mixed. The sensitivity/specificity of the UF-5000 was 80.0/88.2% for gram negative rods and 70.0/86.5% for gram-positive cocci.ConclusionsThe UF-5000 demonstrated the good sensitivity and specificity for Gram-negative bacilli bacteria and demonstrated an improved sensitivity for detecting Gram-positive cocci.

scholarly journals An Intact Cell Bioluminescence-Based Assay for the Simple and Rapid Diagnosis of Urinary Tract Infection

2020 ◽  
Vol 21 (14) ◽  
pp. 5015
Author(s):  
Sherwin Reyes ◽  
Nga Le ◽  
Mary Denneth Fuentes ◽  
Jonathan Upegui ◽  
Emre Dikici ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Tract Infection ◽  
Intact Cell ◽  
Point Of Care ◽  
Photobacterium Leiognathi ◽  
Artificial Urine ◽  
Detection Window ◽  
Tract Infections

Urinary tract infection (UTI) is one of the most common infections, accounting for a substantial portion of outpatient hospital and clinic visits. Standard diagnosis of UTI by culture and sensitivity can take at least 48 h, and improper diagnosis can lead to an increase in antibiotic resistance following therapy. To address these shortcomings, rapid bioluminescence assays were developed and evaluated for the detection of UTI using intact, viable cells of Photobacterium mandapamensis USTCMS 1132 or previously lyophilized cells of Photobacterium leiognathi ATCC 33981™. Two platform technologies—tube bioluminescence extinction technology urine (TuBETUr) and cellphone-based UTI bioluminescence extinction technology (CUBET)—were developed and standardized using artificial urine to detect four commonly isolated UTI pathogens—namely, Escherichia coli, Proteus mirabilis, Staphylococcus aureus, and Candida albicans. Besides detection, these assays could also provide information regarding pathogen concentration/level, helping guide treatment decisions. These technologies were able to detect microbes associated with UTI at less than 105 CFU/mL, which is usually the lower cut-off limit for a positive UTI diagnosis. Among the 29 positive UTI samples yielding 105–106 CFU/mL pathogen concentrations, a total of 29 urine specimens were correctly detected by TuBETUr as UTI-positive based on an 1119 s detection window. Similarly, the rapid CUBET method was able to discriminate UTIs from normal samples with high confidence (p ≤ 0.0001), using single-pot conditions and cell phone-based monitoring. These technologies could potentially address the need for point-of-care UTI detection while reducing the possibility of antibiotic resistance associated with misdiagnosed cases of urinary tract infections, especially in low-resource environments.

scholarly journals Sensitivity of point-of-care testing C reactive protein and procalcitonin to diagnose urinary tract infections in Dutch nursing homes: PROGRESS study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e031269 ◽  
Author(s):  
Sacha D Kuil ◽  
Soemeja Hidad ◽  
Johan C Fischer ◽  
Janneke Harting ◽  
Cees MPM Hertogh ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Nursing Homes ◽  
Study Protocol ◽  
Point Of Care ◽  
Asymptomatic Bacteriuria ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Reference Number ◽  
Tract Infections ◽  
Clinical Rules

IntroductionSuspected urinary tract infection (UTI) ranks among the most common reasons for antibiotic use in nursing homes. However, diagnosing UTI in this setting is challenging because UTI often presents with non-specific symptomatology. Moreover asymptomatic bacteriuria is common in elderly, which complicates attribution of causality to detection of bacteria in urine. These diagnostic challenges contribute to overuse of antibiotics and emergence of antimicrobial resistance in nursing homes. Given the diagnostic challenges, there is a need for point-of-care (POC) diagnostic tests to support clinical rules for diagnosing UTI. Procalcitonin (PCT) and C reactive protein (CRP) are inflammatory blood markers that have been proven useful to support diagnosis and monitoring of (bacterial) respiratory tract infections and sepsis. While limited studies suggest their usefulness in supporting UTI diagnosis, their utility has not been studied in elderly populations for this purpose.Methods and analysisIn a 24-month matched prospective study, ‘PROGRESS’ will assess and compare the sensitivity of rapid POC measurements of blood CRP and PCT levels to support clinical rules for diagnosing UTI in nursing home residents. The primary outcome measure is sensitivity of the POC tests to identify patients with true UTI based on the predefined definition, as derived from receiver operating curves.Ethics and disseminationThis study will be conducted in accordance with Good Clinical Practice guidelines and the principles of the Declaration of Helsinki. The study protocol is approved by the Medical Ethical Committee of Amsterdam UMC location VUmc with reference number 2017.350 and National Central Committee on Research involving Human Subjects with reference number NL62067.029.17.Trial registration numberNTR6467.

scholarly journals Role of age and sex in determining antibiotic resistance in febrile urinary tract infections

2016 ◽  
Vol 51 ◽  
pp. 89-96 ◽  
Author(s):  
Dong Sup Lee ◽  
Hyun-Sop Choe ◽  
Hee Youn Kim ◽  
Je Mo Yoo ◽  
Woong Jin Bae ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Febrile Urinary Tract Infections ◽  
Tract Infections ◽  
Age And Sex

scholarly journals Resistive index in febrile urinary tract infections: predictive value of renal outcome

2004 ◽  
Vol 19 (5) ◽  
pp. 575-575
Author(s):  
G�l �z�elik ◽  
Tug�in Bora Polat ◽  
Seniha Aktas ◽  
Feyzullah �etinkaya
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Predictive Value ◽  
Resistive Index ◽  
Renal Outcome ◽  
Febrile Urinary Tract Infections ◽  
Tract Infections
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