Urine Sediment Findings and the Immune Response to Pathologies in Fungal Urinary Tract Infections Caused by Candida spp.

Fungi are pathogenic agents that can also cause disseminated infections involving the kidneys. Besides Candida, other agents like Cryptococcus spp. can cause urinary tract infection (UTI), as well as other non-yeast fungi, especially among immunocompromised patients. The detection and identification of fungi in urine samples (by microscopy and culture) plays an essential role in the diagnosis of fungal UTI. However, variable cutoff definitions and unreliable culture techniques may skew analysis of the incidence and outcome of candiduria. The sediment analysis plays a key role in the identification of fungal UTI because both yeasts and pseudohyphae are easily identified and can be used as a clinical sign of fungal UTI but should not be overinterpreted. Indeed, urine markers of the immune response (leukocytes), urine barriers of tissue protection (epithelial cells), and urine markers of kidney disease (urinary casts) can be found in urine samples. This work explores the manifestations associated with the fungal UTI from the urinalysis perspective, namely the urinary findings and clinical picture of patients with fungal UTI caused by Candida spp., aspects associated with the immune response, and the future perspectives of urinalysis in the diagnosis of this clinical condition.

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

10.21203/rs.3.rs-121031/v1 ◽

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.

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

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2015-0902 ◽

2015 ◽

Vol 53 (s2) ◽

Cited By ~ 5

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.

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Further evaluation of the test for detection of antibody-coated bacteria in urine sediment

Journal of Clinical Microbiology ◽

10.1128/jcm.5.5.510-513.1977 ◽

1977 ◽

Vol 5 (5) ◽

pp. 510-513

Author(s):

S R Jones ◽

J Johnson

Keyword(s):

Immune Response ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Diagnostic Laboratory ◽

Urine Sediment ◽

Tract Infections ◽

Antibody Coating ◽

Urine Specimens

To assess the reproducibility of the test for detection of antibody-coated bacteria in urine sediment as it might be used in a diagnostic laboratory for classification of urinary tract infections, multiple urine specimens from 83 patients were tested. The results were reproducible and consistent, or if inconsistent potentially explainable, in all but four patients. The explanation for inconsistencies include the immune response to the infecting bacteria, nonspecificity of the antibody coating the bacteria, antibody in prostatic secretions, and antibody-coated bacteria contaminating the urine specimens.

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Prevalence and Impact of Biofilms on Bloodstream and Urinary Tract Infections: A Systematic Review and Meta-Analysis

Antibiotics ◽

10.3390/antibiotics10070825 ◽

2021 ◽

Vol 10 (7) ◽

pp. 825

Author(s):

Henrique Pinto ◽

Manuel Simões ◽

Anabela Borges

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Meta Analysis ◽

Candida Spp ◽

Treatment Interventions ◽

Statistical Confidence ◽

Resistant Strains ◽

Meta Analyses ◽

Tract Infections

This study sought to assess the prevalence and impact of biofilms on two commonly biofilm-related infections, bloodstream and urinary tract infections (BSI and UTI). Separated systematic reviews and meta-analyses of observational studies were carried out in PubMed and Web of Sciences databases from January 2005 to May 2020, following PRISMA protocols. Studies were selected according to specific and defined inclusion/exclusion criteria. The obtained outcomes were grouped into biofilm production (BFP) prevalence, BFP in resistant vs. susceptible strains, persistent vs. non-persistent BSI, survivor vs. non-survivor patients with BSI, and catheter-associated UTI (CAUTI) vs. non-CAUTI. Single-arm and two-arm analyses were conducted for data analysis. In vitro BFP in BSI was highly related to resistant strains (odds ratio-OR: 2.68; 95% confidence intervals-CI: 1.60–4.47; p < 0.01), especially for methicillin-resistant Staphylococci. BFP was also highly linked to BSI persistence (OR: 2.65; 95% CI: 1.28–5.48; p < 0.01) and even to mortality (OR: 2.05; 95% CI: 1.53–2.74; p < 0.01). Candida spp. was the microorganism group where the highest associations were observed. Biofilms seem to impact Candida BSI independently from clinical differences, including treatment interventions. Regarding UTI, multi-drug resistant and extended-spectrum β-lactamase-producing strains of Escherichia coli, were linked to a great BFP prevalence (OR: 2.92; 95% CI: 1.30–6.54; p < 0.01 and OR: 2.80; 95% CI: 1.33–5.86; p < 0.01). More in vitro BFP was shown in CAUTI compared to non-CAUTI, but with less statistical confidence (OR: 2.61; 95% CI: 0.67–10.17; p < 0.17). This study highlights that biofilms must be recognized as a BSI and UTI resistance factor as well as a BSI virulence factor.

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

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2020-0524 ◽

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.

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

Technium BioChemMed ◽

10.47577/biochemmed.v1i1.2451 ◽

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.

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Determination of nitrofurantoin and fosfomycin susceptibility among urinary Escherichia coli isolates

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20203676 ◽

2020 ◽

Vol 8 (9) ◽

pp. 3274

Author(s):

Rachana Kanaujia ◽

Amit Kumar ◽

Malay Bajpai

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Urine Samples ◽

E Coli ◽

Tract Infections ◽

Therapeutic Alternatives ◽

Micro Organisms ◽

Staphylococcus Spp

Background: Urinary tract infections (UTIs) are one of the most common infections. For treatment of UTIs, there are limited antibiotics due to increased resistance among uropathogens. Two older antibiotics; Nitrofurantoin and Fosfomycin have become novel oral therapeutic options against uropathogens. Aim of the study was to identify UTI causing micro-organisms and evaluate in-vitro activity of nitrofurantoin and fosfomycin against most common isolated organism (E. coli).Methods: Results of urine samples culture and susceptibility testing over a period of 1 year were analysed and included in this study.Results: Micro-organisms were isolated from 568 urine samples. Most commonly isolated organism was Escherichia coli (40.50%), followed by Klebsiella spp. (20.07%) and Staphylococcus spp. (17.07%). Susceptibility of E. coli to nitrofurantoin and fosfomycin was 91.74% and 65.65% respectively. Conclusion: Good activity of nitrofurantoin and fosfomycin against E. coli indicates that these two drugs are potential therapeutic alternatives for urinary tract infections.

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Molecular Characterization of Multidrug Resistant Uropathogenic E. Coli Isolates from Jordanian Patients

The Open Microbiology Journal ◽

10.2174/1874285801812010001 ◽

2018 ◽

Vol 12 (1) ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Yacoub R. Nairoukh ◽

Azmi M. Mahafzah ◽

Amal Irshaid ◽

Asem A. Shehabi

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Multidrug Resistant ◽

Urine Samples ◽

Diffusion Method ◽

Molecular Characteristics ◽

Biochemical Tests ◽

E Coli ◽

Tract Infections ◽

St131 Clone

Background: Emergence of multi-drug resistant uropathogenic E. coli strains is an increasing problem to empirical treatment of urinary tract infections in many countries. This study investigated the magnitude of this problem in Jordan. Methods: A total of 262 E. coli isolates were recovered from urine samples of Jordanian patients which were suspected to have urinary tract infections (UTIs). All isolates were primarily identified by routine biochemical tests and tested for antimicrobial susceptibility by disc diffusion method. Fifty representative Multidrug Resistance (MDR) E. coli isolates to 3 or more antibiotic classes were tested for the presence of resistance genes of blaCTX-M- 1, 9 and 15, carbapenemase (blaIMP, blaVIM, blaNDM-1, blaOXA-48), fluoroquinolones mutated genes (parC and gyrA) and clone of ST131 type using PCR methods. Results: A total of 150/262 (57.3%) of E. coli isolates were MDR. Urine samples of hospitalized patients showed significantly more MDR isolates than outpatients. Fifty representative MDR E. coli isolates indicated the following molecular characteristics: All were positive for mutated parC gene and gyrA and for ST131 clone, and 78% were positive for genes of CTX-M-15, 76% for CTX-M-I and for 8% CTX-M-9, respectively. Additionally, all 50 MDR E. coli isolates were negative for carbapenemase genes (blaIMP, blaVIM, blaNDM-1, blaOXA-48), except of one isolate was positive for blaKPC-2 . Conclusion: This study indicates alarming high rates recovery of MDR uropathogenic E. coli from Jordanian patients associated with high rates of positive ST131 clone, fluoroquinolone resistant and important types of blaCTX-M.

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

Journal of Clinical Microbiology ◽

10.1128/jcm.00571-19 ◽

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.

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PREVALÊNCIA DE INFECÇÃO URINÁRIA E DE Actinomyces suis EM PORCAS GESTANTES E SUA CORRELAÇÃO COM ALGUNS PARÂMETROS FÍSICOS E QUÍMICOS DA URINA

Archives of Veterinary Science ◽

10.5380/avs.v5i1.3890 ◽

2000 ◽

Vol 5 (1) ◽

Cited By ~ 3

Author(s):

G.C. ALBERTON ◽

P.R. WERNER ◽

J. SOBESTIANSKY ◽

O.D. COSTA ◽

W. BARIONI JÚNIOR

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Urinary Infection ◽

Urine Samples ◽

Chemical Parameters ◽

Presumptive Diagnosis ◽

Urinary Infections ◽

Physical And Chemical Parameters ◽

Tract Infections ◽

Physical And Chemical

O presente trabalho teve como objetivo determinar a prevalência de infecção urinária e da bactéria Actinomyces suis na urina de 1745 porcas gestantes da região Sul do Brasil e correlacionar essa prevalência com parâmetros físicos e químicos da urina. A prevalência de infecção urinária e de A. suis foi de 28,31% e 20,63%, respectivamente. Observou-se correlação negativa entre infecção urinária e A. suis, ou seja, as porcas que apresentaram infecção urinária tinham menor prevalência de A. suis (13,67%) do que as que não a apresentaram (23,12%). Da mesma forma, as porcas portadoras de A. suis, tinham menor prevalência de infecção urinária (17,43%) do que as não portadoras (28,62%). Apenas 3,60% das porcas examinadas eram positivas para infecção urinária e A. suis simultaneamente. A cor predominante da urina foi a amarelo claro, tanto para as porcas portadoras ou não portadoras de infecção urinária ou de A. suis. Constatou-se a presença de turbidez em 83,15% das amostras, sendo que em 96,18% das amostras turvas observou-se a presença de cristais. Finalmente, a cor, aspecto, densidade, pH e presença de cristais, foram considerados como parâmetros sem valor para o diagnóstico presuntivo de infecção urinária em porcas gestantes. Prevalence of urinary tract infections and of Actinomyces suis in urine from pregnant sows. Correlation with some urines physical and chemical parameters Abstract A survey has been carried out in urine samples from 1745 pregnant sows from Southern Brazil, in regard to the prevalence of urinary infections and of Actinomyces suis and its correlation with some of the urine physical and chemical parameters. Prevalence of urinary infections was of 28.31% and that of A. suis, 20.63%. However, a negative correlation has been found between the incidence of urinary infection and the presence of A. suis, the prevalence of the latter being lower in sows which are positive for urinary infections (13.67%) than in those without urinary infection (23.12%). At the same time, sows positive for A. suis display a lesser number of urinary infection (17.43%) than those negative for the bacteria (28.62%). Only in 3.60% of the sows, urinary infection and A. suis occurred simultaneously. Due to the presence of crystals, turbidity was frequently observed in sows urine (83.15%). Crystals were present in 96.18% of sows turbid urine samples. Furthermore, color, turbidity, density, pH and the presence of crystals were not considered of value for the presumptive diagnosis of urinary tract infections in pregnant sows.

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