Comparative analysis of bacteriuria results on routine urinalysis and urine culture: a retrospective study

Bacterial urinary tract infections (UTI) are among the most frequent infectious diseases of small animals. Although antimicrobial therapy is recommended for treating bacterial UTIs, the current consensus is that treatment may not be necessary for asymptomatic animals. The aim of this study was to evaluate the diagnostic ability of urinalysis to detect bacteriuria and to compare it with urine culture (gold standard method) to assess the risk of false-positive results. A retrospective study was conducted from January 2016 to July 2019 and urine samples of 119 dogs were analyzed. Diagnostic validation was performed for urinalysis, based on the morphological classification and intensity of bacteriuria. Agreement between the results was assessed using the kappa (k) index. When the presence of cocci was used as a diagnostic criterion to suggest bacteriuria, it was observed that the agreement (k = -0.006) was lower than that expected by chance. However, a poor agreement (k = 0.22) was also found for bacilli during urinalysis (k = 0.23). A significant degree of agreement was observed in cases with high intensity of bacteriuria. Therefore, urine culture must be performed for conclusive evidence of bacteriuria to avoid false-positive results during urinalysis.

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Predictive utility of prior positive urine culture of extended- spectrum β -lactamase producing strains

PLoS ONE ◽

10.1371/journal.pone.0243741 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0243741

Author(s):

Basima A. Almomani ◽

Rawand A. Khasawneh ◽

Rola Saqan ◽

Munther S. Alnajjar ◽

Lara Al-Natour

Keyword(s):

Hospital Admissions ◽

Urine Culture ◽

Empiric Therapy ◽

Empiric Antibiotic Therapy ◽

Positive Urine Culture ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum ◽

Positive Urine ◽

Tract Infections ◽

Positive Results

Rising incidence of extended- spectrum beta-lactamase (ESBL) induced urinary tract infections (UTIs) is an increasing concern worldwide. Thus, it is of paramount importance to investigate novel approaches that can facilitate the identification and guide empiric antibiotic therapy in such episodes. The study aimed to evaluate the usability of antecedent ESBL-positive urine culture to predict the pathogenic identity of future ones. Moreover, the study evaluated the accuracy of selected empiric therapy in index episodes. This was a retrospective study that included 693 cases with paired UTI episodes, linked to two separate hospital admissions within 12 month-period, and a conditional previous ESBL positive episode. Pertinent information was obtained by reviewing patients’ medical records and computerized laboratory results. Multivariate analysis showed that shorter interval between index and previous episodes was significantly associated with increased chance of ESBL-positive results in current culture (OR = 0.912, 95CI% = 0.863–0.963, p = 0.001). Additionally, cases with ESBL-positive results in current culture were more likely to have underlying urological/surgical condition (OR = 1.416, 95CI% = 1.018–1.969, p = 0.039). Investigations of the accuracy of current empirical therapy revealed that male patients were less accurately treated compared to female patients (OR = 0.528, 95CI% = 0.289–0.963, p = 0.037). Furthermore, surgical patients were treated less accurately compared to those treated in internal ward (OR = 0.451, 95CI% = 0.234–0.870, p = 0.018). Selecting an agent concordant with previous microbiologic data significantly increased the accuracy of ESBL-UTIs therapy (p<0.001). A quick survey of the previous ESBL urine culture results can guide practitioners in the selection of empiric therapy for the pending current culture and thus improve treatment accuracy.

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P034 Inter-scorer concordance impacts MSLT results

SLEEP Advances ◽

10.1093/sleepadvances/zpab014.082 ◽

2021 ◽

Vol 2 (Supplement_1) ◽

pp. A32-A32

Author(s):

N Eriksson ◽

P Teuwen ◽

E Mateus ◽

C Shim ◽

A Scott

Keyword(s):

Retrospective Study ◽

Positive Result ◽

False Positive ◽

Sleep Latency ◽

Spearman Correlation ◽

Percentage Agreement ◽

Medical Interpretation ◽

Rem Latency ◽

Multiple Sleep Latency ◽

Positive Results

Abstract Introduction A retrospective study on the effect of inter-scorer concordance and impact of analysing polysomnography (PSG) data prior to the Multiple Sleep Latency Test (MSLT) on clinical interpretation of Narcolepsy (N) and Idiopathic Hypersomnolence (IH). Methods Data of four individuals was randomly selected from a cohort of patients that participated in MSLT studies. De-identified MSLT fragments from four nap periods (n=16) were scored in two groups: analysis of PSG conducted prior to the respective MSLT fragments, and analysis without access to prior PSG. Individual scorers were compared to a master score set, by consensus from two experienced sleep scientists. Spearman correlation and percentage agreement statistics were applied to calculate the inter-scorer concordance in sleep latency and REM latency. Mann-Whitney test was utilised to assess differences between the two groups. A positive result was assigned as: mean (n=4) sleep latency of <10min (IH), and mean (n=4) sleep latency of <8min including (n=2) SOREMs (N). Results From 16 sets of data, four false positive results were identified when PSG was not analysed prior to scoring the MSLT fragments. Additionally, statistically significant differences were present when PSG analysis was conducted prior to scoring MSLT sleep latency and REM latency data. Discussion These results support a recommendation that PSG analysis (sleep and REM latency) should be encouraged prior to MSLT studies and performed by the same sleep scientist. Furthermore, including MSLT data in intra-lab concordance activities is important, particularly in relation to medical interpretation and practice.

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Retrospective study of false positive results in in vitro genotoxicity studies

Toxicology Letters ◽

10.1016/j.toxlet.2013.05.246 ◽

2013 ◽

Vol 221 ◽

pp. S131

Author(s):

Hana Hofman-Hüther

Keyword(s):

Retrospective Study ◽

False Positive ◽

Positive Results ◽

In Vitro Genotoxicity

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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 ◽

10.1161/str.46.suppl_1.wp344 ◽

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.

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Infeções Urinárias Causadas por Enterobacteriaceae Produtoras de β-Lactamases de Espetro Expandido Adquiridas na Comunidade num Hospital de Nível III - Um Estudo Retrospetivo

Acta Médica Portuguesa ◽

10.20344/amp.12338 ◽

2020 ◽

Vol 33 (7-8) ◽

pp. 466

Author(s):

Ana Simões ◽

Margarida Lima ◽

Ana Brett ◽

Carolina Queiroz ◽

Catarina Chaves ◽

...

Keyword(s):

Escherichia Coli ◽

Retrospective Study ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Urine Culture ◽

Urinary Infection ◽

Proteus Vulgaris ◽

Paediatric Hospital ◽

Urinary Infections ◽

Tract Infections

Introduction: The emergence of β-lactamases producing bacteria is a problem worldwide, with increasing importance in communityacquired infections, especially in urinary tract infections. Data regarding the use of non-carbapenem antimicrobials in these infections are scarce. The aim of this study was to analyse the treatment and outcome of urinary tract infections caused by community-acquired β-lactamase-producing bacteria in children.Material and Methods: Retrospective study performed in a level III paediatric hospital, between June 2007 and December 2017. All children with β-lactamase-producing Enterobacteriaceae identified in aseptically collected urine culture were included.Results: A total of 175 urinary infections caused by β-lactamases producing bacteria were diagnosed, 34 (19%) were community-acquired: 25 Escherichia coli (74%), 4 Klebsiella pneumoniae (12%), 4 Proteus mirabilis (12%) and 1 Proteus vulgaris (3%). In 30 (88%) cases, it was the first urinary infection. After identification of the microorganism and antimicrobial susceptibility, 33 (97%) children were re-evaluated and 24 (71%) had a repeat urine culture, which was positive in three (13%). In six (18%) cases, antibiotic treatment was modified. Four (12%) children had another UTI in the following month. In 30 (88%) children, imaging was carried out, with no nephrourological malformations detected.Discussion: In the last decade, about 20% of urinary infections caused by β-lactamase-producing Enterobacteriaceae were community-acquired with a relatively stable number of cases over the years. No nephro-urological malformations were identified in these children.Conclusion: Although the number of cases is small, the clinical and microbiological outcomes showed that most were successfully treated with non-carbapenem antibiotics, with low recurrence of new episodes of urinary tract infections.

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Comparison of the reliability of Gram-negative and Gram-positive flags of the Sysmex UF-5000 with manual Gram stain and urine culture results

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2020-1263 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Dietmar Enko ◽

Ingeborg Stelzer ◽

Michael Böckl ◽

Wolfgang J. Schnedl ◽

Andreas Meinitzer ◽

...

Keyword(s):

Predictive Value ◽

Urine Culture ◽

Youden Index ◽

Gram Stain ◽

Gram Positive ◽

Urine Sediment ◽

Gold Standard Method ◽

Gram Negative ◽

Tract Infections ◽

Culture Positive

AbstractObjectivesRecently, the fully automated flow cytometry-based UF-5000 (Sysmex Corboration, Kobe, Japan) urine sediment analyzer was developed providing bacteria (BACT) info flags for more accurate bacterial discrimination of urinary tract infections (UTIs). This study aimed to compare the reliability of the UF-5000 BACT-info flags with manual Gram stain and urine culture as the gold standard method.MethodsA total of 344 urine samples were analyzed on the UF-5000 and compared with manual microscopic Gram stain and urine cultures. Agreement was assessed by Cohen’s kappa (κ) analysis. The Youden index was used to determine the optimal BACT and white blood cell (WBC) cut-off points for discriminating positive and negative urine cultures.ResultsOverall 98/344 (28.5%) samples were urine culture positive at a cut-off of ≥105 CFU/mL. “Gram-negative?” UF-5000 BACT-Info flags showed a better concordance of 25/40 (62.5%) with urine culture compared to Gram stain with 30/50 (60%). The results for UF-5000 discrimination of Gram-positive and Gram-negative microorganisms demonstrated a substantial (κ = 0.78) and fair (κ = 0.40) agreement with urine culture. Optimal cut-off points detecting positive urine cultures were 135 BACT/µL (sensitivity [SE]: 92.1%, specificity [SP]: 85.4%, positive predictive value [PPV]: 71%, negative predictive value [NPV]: 96%) and 23 WBC/µL (SE: 73.5%, SP: 84.1%, PPV: 65%, NPV: 89%).ConclusionsThe UF-5000 analyzer (Sysmex) is a reliable diagnostic tool for UTI screening. The displayed BACT-Info flags allow a quick diagnostic orientation for the clinician. However, the authors suggest verifying the automated Gram categories with urine culture.

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Critical Evaluation of Impedance Phlebography for the Diagnosis of Deep Vein Thrombosis

Thrombosis and Haemostasis ◽

10.1055/s-0038-1649161 ◽

1974 ◽

Vol 31 (02) ◽

pp. 273-278

Author(s):

Kenneth K Wu ◽

John C Hoak ◽

Robert W Barnes ◽

Stuart L Frankel

Keyword(s):

Deep Vein Thrombosis ◽

False Positive ◽

False Negative ◽

Critical Evaluation ◽

Original Method ◽

Vein Thrombosis ◽

Negative Results ◽

False Negative Results ◽

Deep Vein ◽

Positive Results

SummaryIn order to evaluate its daily variability and reliability, impedance phlebography was performed daily or on alternate days on 61 patients with deep vein thrombosis, of whom 47 also had 125I-fibrinogen uptake tests and 22 had radiographic venography. The results showed that impedance phlebography was highly variable and poorly reliable. False positive results were noted in 8 limbs (18%) and false negative results in 3 limbs (7%). Despite its being simple, rapid and noninvasive, its clinical usefulness is doubtful when performed according to the original method.

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Dynamics of symptoms of genitourinary menopausal syndrome and the frequency of recurrence of lower urinary tract infection in women in periand postmenopausal patients with combined therapy with Trioginal®

GYNECOLOGY ◽

10.26442/20795696.2018.6.180119 ◽

2018 ◽

Vol 20 (6) ◽

pp. 67-72

Author(s):

D Yu Pushkar ◽

M Yu Gvozdev

Keyword(s):

Urinary Tract ◽

Lower Urinary Tract ◽

Urine Culture ◽

Objective Assessment ◽

Control Group ◽

Urination Disorders ◽

Menopausal Syndrome ◽

Tract Infections ◽

Two Stages ◽

Lower Urinary

Material and methods. The study included patients (n=164) in peri- and postmenopause, having a laboratory-confirmed picture of the genitourinary menopausal syndrome - atrophic vulvovaginitis and suffering from recurrent lower urinary tract infections (UTI) - cystitis and urethritis. All patients underwent standard antibacterial therapy (ABT) UTI in accordance with the results of bacteriological urine culture according to Russian clinical guidelines on urology. Against the background of ABT, 164 patients received additional therapy with Trioginal® (the study group - SG) containing estriol, micronized progesterone and Lactobacillus casei rhamnosus Doderleini 35 (LCR 35) lactobacillus strain. Trioginal® was administered intravaginally in two stages: for 20 days, 2 capsules per day, then for 10 days, 1 capsule per day. In the comparison group - CG (n=67) with ABT, Ovipol Klio® (estriol monopreparation) was additionally intravaginally used in two stages: for 14 days, 1 suppository per day, then for 2 weeks, 1 suppository 2 times a week. The control group consisted of 30 patients receiving only standard ABT UTI, local hormone therapy for vulvovaginal atrophy (VVA) was not performed. The observation period was 12 months after the end of the course of therapy. At all stages of treatment, a subjective and objective assessment of the severity of urination disorders and urogenital atrophy (UDI-6 questionnaire), their impact on the quality of life of patients (questionnaire IIQ-7), indicators of bacteriuria, bacterial urine culture and vaginal biocenosis, frequency of undesirable phenomena were carried out. According to the initial characteristics of the group of patients were comparable. Results. At all stages of the study, in the group of patients who received therapy with the use of the Trioginal® drug, there was a significant improvement in the clinical picture of urination disorders compared to the CG and the control (main) group - MG (in SG - 18% at the end of therapy versus 100% before the start of therapy; CG - 26 % versus 100% respectively; Ledger - 58% versus 100% respectively; p

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Prevalence of SHV-extended spectrum β-lactamase producing carbapenem –resistantKlebsiellapneumoniae among patients with lower respiratory tractinfections in Babylon Province-Iraq.

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v9ispl1.1299 ◽

2018 ◽

Vol 9 (SPL1) ◽

Author(s):

Fatima Moeen Abbas

Keyword(s):

Resistance Rate ◽

Combination Method ◽

Diffusion Method ◽

Disk Diffusion Method ◽

Carbapenem Resistant ◽

Extended Spectrum ◽

Pcr Method ◽

Polymerase Chain ◽

Tract Infections ◽

Positive Results

This study was carried out to screen the prevalence of Klebsiella pneumoniae isolated from patients with lower respiratory tract infections in Babylon province.From December,2015 to the end of March,2016,a total of 100 sputum samples were collected from patients visited or hospitalized Merjan Teaching Hospital and Al- Hashimya General Hospital. Fifteenth (65%) isolates were identified as Klebsiellapneumoniae. All bacterial isolates were evaluated for extended spectrum β-lactamase (ESBL) production phenotypically using disk combination method. Eleven (73.3%) isolates were detected as ESBL-producers. Kirby-Bauer disk diffusion method was employed to determine resistance profile of ESBLs-positive isolates. Higher rates of resistance were observed for ampicillin and piperacillin antibiotics with (81.8%) and (72.7%) resistance rate, respectively, while the lowest rate was noticed for imipenem antibiotic (14.28%). Carbapenem-resistant isolates were investigated for blaSHV gene by Polymerase Chain Reaction (PCR) method, 2 (100%) isolates gave positive results.

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