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.

scholarly journals Significant bacteriuria among requested repeat urine samples and its clinical correlation

2021 ◽  
Author(s):  
Arjun Bhugra ◽  
Supriya Gachinmath
Keyword(s):  
Escherichia Coli ◽  
Bacterial Infections ◽  
Urine Culture ◽  
Asymptomatic Bacteriuria ◽  
Urine Samples ◽  
Clinical Correlation ◽  
Normal Flora ◽  
Sensitivity Pattern ◽  
Significant Bacteriuria ◽  
Tract Infections

Background and Objectives: Urinary tract infections (UTI) are the most common bacterial infections in both outpatient and inpatient department received for routine bacterial culture and sensitivity. We looked for significant bacteriuria in re- quested repeat urine sample after primary urine culture yielded significant growth (>105  CFU/ml) of ≥3 types of colonies. Also studied, different isolates grown with their sensitivity pattern and contamination rates of urine samples from different departments. Materials and Methods: In routine, primary urine cultures yielding ≥3 types of colonies on Cystine Lactose Electrolyte Deficient (C.L.E.D) were requested for repeat samples, collected with aseptic precautions after proper instructions. Data was analyzed for the Microbiological profile and its clinical correlation. Results: Among 617 received requested urine samples, 292 (47.3%) yielded significant bacteriuria. Clinical details were available for 252 cases out of which 100 (39.7%) showed asymptomatic bacteriuria, 87 (34.5%) complicated UTI and 65 (25.7%) uncomplicated UTI. Null hypothesis was rejected as 292 (47.3%) of the received repeat samples showed significant bacteriuria and 325 (53%) showed normal flora/no growth i.e. there is a 50% chance of getting either a positive culture or normal flora/no growth in repeat urine samples after the primary urine culture showed ≥3 types of colonies. It indicates the importance of requesting repeat urine samples for an accurate urine culture report. Male patients were significantly associ- ated with significant bacteriuria and complicated UTI (p= 0.001). Escherichia coli (n=112, 28%) was the most common fol- lowed by Klebsiella species (n=66, 16.4%) and Enterococcus species (n=69, 17.2%). 183 (45.6%) isolates were Multi-Drug Resistant (MDR) Gram Negative Bacilli (GNBs), Escherichia coli (50.3%) being most common. Vancomycin Resistant Enterococcus (VRE) (n=8, 2.0%) was also isolated. Conclusion: Our study justifies the rationale for asking a repeat urine samples which helps in providing an appropriate mi- crobiological report with antibiotic sensitivity pattern, hence preventing unwanted reporting of commensals/contaminants facilitating evidence based therapy.

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.

Antibacterial activity of Urena lobata against uropathogens

2021 ◽  
Vol 25 (1) ◽  
pp. 43-46
Author(s):  
Taofeeq Garuba ◽  
Nency Katrodiya ◽  
Nikita Patel ◽  
Swetal Patel ◽  
Dhanji. P. Rajani ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Agar Plate ◽  
Soxhlet Extraction ◽  
Inhibitory Effect ◽  
Urine Samples ◽  
Herbal Extract ◽  
Mannitol Salt Agar ◽  
Methanolic Extracts ◽  
Tract Infections

Urinary tract infections (UTI) are one of the most common form of bacterial infections but the treatment becomes cumbersome as the etiological bacteria are developing resistance against antibiotics. This present study evaluated the efficacy of antimicrobial   activity of Urena lobata against uropathogens. Six urine samples from UTI patients were collected from Pathological Laboratory, G.B. Vaghani Multispecialty Hospital, Surat. Bacteria were isolated from these samples using Nutrient agar, Mac Conkey agar plate, Blood agar, Mannitol salt agar, Eosin Methylene Blue agar and King’s agar. The bacterial isolates were identified using cultural  characteristics, microscopic features and biochemical characteristics. Leaf extract of Urena lobata was prepared using Soxhlet Extraction Method whereby methanol and distilled water were the extractants used. Herbal extract disc was prepared at  concentrations of 50,75, and100 mg/ml and tested against all the isolates. DMSO and antibiotics (Nitrofurantion, Amikacin, Levofloxacin, Norofloxacin, Ofloxacin and Cephalosporins) were used as negative and positive controls respectively.Staphylococcus aureus, Escherichia coli, Bacillus cereus, Streptococcus pneumoniae, Klebsiella spp. and Brevibacillus panacihumi were isolated from the urine samples. All concentrations of aqueous and methanolic extracts of U. lobata leaf displayed highest zone of inhibition against B. cereus. No inhibitory effect was observed against the growth of Klebsiella except at the highest concentrations. Further study is encouraged on the in-vivo study of efficacy of U. lobata on etiological agent of UTI.

scholarly journals A comparative study of various screening tests of Asymptomatic Bacteriuria in pregnant women attending Antenatal Outpatient Department’

2021 ◽  
Vol 7 (4) ◽  
pp. 170-175
Author(s):  
Dr. Savitha B Hiremath ◽  
Keyword(s):  
Urinary Tract ◽  
Pregnant Women ◽  
Predictive Value ◽  
Bacterial Infections ◽  
Asymptomatic Bacteriuria ◽  
Outpatient Department ◽  
Screening Tests ◽  
Screening Methods ◽  
Tract Infections ◽  
Urine Microscopy

Introduction: Urinary tract infections are the most common bacterial infections in pregnancy.Asymptomatic bacteriuria (ASB) refers to the presence of bacteria in the urine of an individualwithout symptoms of urinary tract infection. ASB which occurs in 2-11% of pregnancies is a majorpredisposition to the development of pyelonephritis. Aims and objectives: The aims and objectivesof the study were to: Study the effectiveness of various screening tests: urine microscopy, gramstain, catalase test, leukocyte esterase test and nitrite test and to compare their sensitivity,specificity, positive predictive value and negative predictive value. Materials and Methods: Thestudy included 500 pregnant women attending the outpatient department over 18 months. The urinesamples collected in sterile containers were screened for urine microscopy, gram stain, catalase test,leukocyte esterase test and nitrite test. The samples were processed on CLED (Cysteine lactoseelectrolyte deficient) agar as the standard against which other screening tests are identified.Results: Gram’s stain (89.34%) was the most sensitive of all and the least reliable test was thecatalase test among the methods of screening tests. Conclusion: Urine culture is considered to bethe gold standard in detecting ASB in pregnant women. Gram’s stain of urine is a good screeningtest when compared to other screening methods. Screening for bacteria in all trimesters isnecessary to prevent the dangerous complications associated with ASB.

scholarly journals Association between the frequency of disposable diaper changing and urinary tract infection in children

2013 ◽  
Vol 53 (2) ◽  
pp. 70
Author(s):  
Meirina Daulay ◽  
Rosmayanti Siregar ◽  
Oke Rina Ramayani ◽  
Supriatmo Supriatmo ◽  
Rafita Ramayati ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urine Culture ◽  
Bacterial Count ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Disposable Diaper ◽  
Disposable Diapers ◽  
Tract Infections

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.

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.

Review of Enterococci Isolated from Canine and Feline Urine Specimens from 2006 to 2011

2015 ◽  
Vol 51 (3) ◽  
pp. 148-154 ◽  
Author(s):  
Kate S. KuKanich ◽  
Brian V. Lubbers
Keyword(s):  
Medical Records ◽  
Urine Culture ◽  
Bacterial Species ◽  
Clinical Signs ◽  
Multidrug Resistant ◽  
Urine Sediment ◽  
Colony Forming Units ◽  
Enterococcus Spp ◽  
Tract Infections ◽  
Urine Specimens

Canine and feline urine culture reports and medical records were reviewed at a veterinary teaching hospital from 2006 to 2011 for enterococcal growth, coinfections, antimicrobial resistance, urine sediment findings, clinical signs, and concurrent conditions. Of all of the urine specimens with significantly defined colony-forming units/mL, Enterococcus (E.) faecalis was the only enterococci isolated from cats and predominated (77.4%) in dogs followed by E. faecium (12.9%), E. durans (3.2%), and other Enterococcus spp. (6.5%). The majority of specimens with significant enterococcal growth resulted in complicated urinary tract infections in 83.9% of dogs and 81.8% of cats. Specimens with only enterococcal growth were more common than those mixed with other bacterial species. Cocci were observed in urine sediments of 8 out of 8 cats and 21 out of 25 dogs with available concurrent urinalyses. Pyuria was noted in 5 out of 8 feline and 15 out of 25 canine urine sediments, and pyuria in dogs was associated with growth of only enterococci on aerobic urine culture. Multidrug resistance was identified in 6 out of 11 cats and 7 out of 31 dogs, and E. faecium isolates from dogs were 4.5× more likely to be multidrug resistant than E. faecalis.

scholarly journals Use of Sysmex UF-5000 flow cytometry in rapid diagnosis of urinary tract infection and the importance of validating carryover rates against bacterial count cut-off

2021 ◽  
Vol 70 (12) ◽  
Author(s):  
Kjersti Haugum ◽  
Maria Schei Haugan ◽  
Jannicke Skage ◽  
Mariann Tetik ◽  
Aleksandra Jakovljev ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
Bacterial Growth ◽  
Roc Curve ◽  
Urine Culture ◽  
Bacterial Count ◽  
Urine Flow ◽  
Urine Samples ◽  
Rapid Screening ◽  
Cross Contamination ◽  
Rule Out

Introduction. Urinary tract infections are common bacterial infections worldwide. Urine culture is the gold standard method to identify and quantify the presence or absence of bacteria in urine. Flow cytometry, which can differentiate and quantify multiple particles (including bacteria) in the urine, presents an alternative method for rapid screening to rule out bacteriuria. Hypothesis. Adding flow cytometry to identify urine samples without bacteriuria could substantially reduce the number of urine samples that need to be cultured as well as the response time for negative results. However, the level of instrument rinsing between samples could affect sample-to-sample carryover rate, a concept given little attention in previous studies. Aim. We aimed to evaluate urine flow cytometry as a rapid screening method to identify urine samples without significant bacterial growth, including analyses of cross-contamination and sample-to-sample carryover rate. Methodology. We analysed 3919 urine samples by quantitative urine culture and flow cytometry screening (Sysmex UF-5000). Receiver operator characteristic (ROC) curve analyses were used to test method agreement to identify: (a) positive vs. negative culture and (b) mixed vs. pure culture. In addition, we performed carryover and cross-contamination studies. Results. ROC curve analyses identified bacterial count (BACT ml−1) and leucocyte count (WBC µl−1) as possible predictors of bacterial growth in the total material and subpopulations, except pregnant women (n=451). This subgroup was excluded from further analyses, leaving a final 3468 urine samples. Area under the ROC curve was 0.94 (95 % CI 0.93–0.95) and 0.81 (95 % CI 0.79–0.82) for bacterial and leucocyte count, respectively. A bacterial count cut-off of 30 BACT ml−1 resulted in 95.2 % sensitivity and 91.2 % negative predictive value, resulting in approximately 30 % of urine samples that could be reported as negative without culture. Use of high-level rinse modes was necessary to ensure carryover rates <0.05 %. Conclusion. Flow cytometry is a suitable and rapid method to rule out urine samples without significant bacterial growth. Rinses between samples should be adjusted, depending on the cut-off used, to prevent sample-to-sample carryover, whereas cross-contamination can be eliminated by the use of separate urine aliquots for flow cytometry analysis and urine culturing respectively.

scholarly journals A study of prevalence of asymptomatic bacteriuria in pregnant women from rural areas attending to Obstetric Department in Akash Hospital, Karnataka, India

2019 ◽  
Vol 8 (7) ◽  
pp. 2845
Author(s):  
Rohini N. S. ◽  
Ravishankar S. N. ◽  
Kala K. ◽  
Rakshith N. R.
Keyword(s):  
Pregnant Women ◽  
Urine Culture ◽  
Screening Method ◽  
Asymptomatic Bacteriuria ◽  
Significant Risk ◽  
Screening Tests ◽  
Rapid Screening ◽  
Screening Methods ◽  
Gram Staining ◽  
In Pregnancy

Background: Asymptomatic bacteriuria (ASB) in pregnancy is a significant risk factor for developing upper urinary tract infection and pyelonephritis which is associated with significant maternal and fetal risks. The aim of this study was to know the prevalence of asymptomatic bacteriuria in pregnancy, to identify the organisms and their antibiotic susceptibility patterns and to formulate a single or combined rapid screening method as an acceptable alternative to urine culture.Methods: A total of 375 pregnant women aged between 18 to 45 years were included in this study. Clean catch mid-stream urine samples were collected. Screening tests done were gram staining of uncentrifuged urine, pus cell count, nitrite test and leukocyte esterase test. Identification of pathogens and antibiotic sensitivity tests were performed as per standard urine culture and sensitivity methods.Results: Out of the 375 pregnant women, 31 (8.4%) had significant bacteriuria. High percentage of women with ASB were primigravidas (51.38%) and in 2nd trimester (43.86%). The most common organism isolated was E.coli (56.14%). In screening tests, gram staining of uncentrifuged urine had a sensitivity of 85.71%. Sensitivity of 71.42% was found in Nitrite and leucocyte esterase tests. However, the combination of these two tests, with either test positive, showed sensitivity and negative predictive value of 90.47% and 99.09% respectively.Conclusions: Early detection and treatment of ASB in pregnancy can prevent complications. ASB can be identified by simple and combined rapid screening methods and urine culture along with antibiogram. Therefore, screening and treatment of ASB may be incorporated as routine antenatal care for safe motherhood and healthy newborn.

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

2020 ◽  
Vol 6 (4) ◽  
pp. 245
Author(s):  
José Antonio Tesser Poloni ◽  
Liane Nanci Rotta
Keyword(s):  
Immune Response ◽  
Urinary Tract ◽  
Urine Samples ◽  
Candida Spp ◽  
Urine Sediment ◽  
Culture Techniques ◽  
Detection And Identification ◽  
Identification Of Fungi ◽  
Tract Infections ◽  
Urine Markers

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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