Prediction of urine culture results by automated urinalysis with digital flow morphology analysis

Kim, Do Kyun; Oh, Seoung Chul; Liu, Changseung; Kim, Yoonjung; Park, Yongjung; Jeong, Seok Hoon

doi:10.1038/s41598-021-85404-1

Cited by 4 publications

(5 citation statements)

References 22 publications

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“…The features of the studied method can also be crucial information for diagnostic purposes in microbiology labs ( Kim et al., 2021 ). The presence or absence of inflammation in the urinary tract can be predicted by bacteria and white blood cells.…”

Section: Discussionmentioning

confidence: 99%

A novel approach to screening and managing the urinary tract infections suspected sample in the general human population

Szmulik¹,

Trześniewska-Ofiara

Mendrycka

et al. 2022

Front. Cell. Infect. Microbiol.

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BackgroundAutomated urine technology providing standard urinalysis data can be used to support clinicians in screening and managing a UTI-suspected sample. Fully automated urinalysis systems have expanded in laboratory practice. Commonly used were devices based on digital imaging with automatic particle recognition, which expresses urinary sediment results on an ordinal scale. There were introduced fluorescent flow cytometry analyzers reporting all parameters quantitatively. There is a need to harmonize the result and support comparing bacteria and WBC qualitative versus semiquantitative results.MethodsA total of 1,131 urine samples were analyzed on both automated urinalysis systems. The chemical components of urinalysis (leukocyte esterase and nitrate reductase) and the sediment results (leukocytes and bacteria) were investigated as potential UTI indicators. Additionally, 106 specimens were analyzed on UF-5000 and compared with culture plating to establish cut-offs that can be suitable for standard urinalysis requirements and help to guide on how to interpret urinalysis results in the context of cultivation reflex.ResultsThe medians of bacteria counts varies from 16.2 (absence), 43.0 (trace), 443.5 (few), 5,389.2 (moderate), 19,356.6 (many) to 32,545.2 (massive) for particular digital microscopic bacteriuria thresholds. For pyuria thresholds, the medians of WBC counts varies from 0.8 (absence), 2.0 (0-1), 7.7 (2-3), 21.3 (4-6), 38.9 (7-10), 61.3 (11-15) to 242.2 (>30). Comparing the culture and FFC data (bacterial and/or WBC counts) was performed. Satisfactory sensitivity (100%), specificity (83.7%), negative predictive value (100%), and positive predictive value (75%) were obtained using indicators with the following cut-off values: leukocytes ≥40/µl or bacteria ≥300/µl.ConclusionsAccurate urinalysis gives information about the count of bacteria and leukocytes as useful indicators in UTIs, in general practice it can be a future tool to cross-link clinical and microbiology laboratories. However, the cut-off adjustments require individual optimization.

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Section: Discussionmentioning

confidence: 99%

A novel approach to screening and managing the urinary tract infections suspected sample in the general human population

Szmulik¹,

Trześniewska-Ofiara

Mendrycka

et al. 2022

Front. Cell. Infect. Microbiol.

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“…9,10 Frequently used screening items such as microscopy analysis for WBCs and bacteria as well as dipstick testing and nitrite in urine are fast but with low sensitivity yet still costly. 7,[10][11][12] Therefore, rapid screening, accurate prediction yet affordable of culture results are needed for clinicians shorten the diagnosis time, improve the efficiency and accomplish the treatment opportunity for patients as early as possible. Hematological parameters are easily measured at low cost using modern hematological analyzers.…”

Section: Original Research Articlementioning

confidence: 99%

Correlation between Hematologic Parameters and Asymptomatic Bacteriuria in the Full-Term Pregnant Patients in Dr. Kariadi Hospital, Semarang, Indonesia

Sukri

2022

Diponegoro. Int. Med. J.

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Objective: We investigated the role of hematologic parameter such as hemoglobin, white blood cells, platelet, hemoglobin platelet ratio (HPR), hemoglobin white blood cells ratio (HWR) in full-term pregnant patients and correlate the result with their urine culture following delivery. Methods: Between 2019-2020, a total number of 95 pregnant patients were retrospectively evaluated at the maternal ward.Results: The average age of the subjects was 29.15 (SD ± 5.95), median of parity of 2 (range 1- 4) and mean of gestational age was 37.5 (SD ± 1.67). There is no difference between groups on the surgery types and comorbidities condition. Among the patients, 14 urine cultures produced growth of 105 CFU/ml bacteria. Pearson’s correlation test showed that leukocyte inversely correlated with bacteriuria, meanwhile hemoglobin white blood cell ratio (HWR) is positively correlated with urinary culture result. In the diagnostic performance, HWR had AUC of 0.765 with sensitivity and specificity of 78.6% and 64.2% respectively at the cut off of 11.92.Conclusions: Prediction of asymptomatic bacteriuria in pregnant patient by simple calculation of HWR might be helpful in significantly reducing workload and costs of urine culture. It is a great advantage that the parameters we use in our work are easily accessible and can be performed in emergency conditions.

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“…It is also common to include the examination of urinary sediment (manual or automated) to determine the presence of bacteria, leucocyturia and haematuria [4,[6][7][8][9][10]. Although guidelines recommend a longer BA culture of 48 hours [3], many laboratories still use a period of 18-24 hours [11][12][13][14]. In fact, in some published studies, the incubation time of cultures is not even mentioned [10].…”

Section: Introductionmentioning

confidence: 99%

Improving the diagnosis of urinary tract infections by the use of enriched media and a 48-hour incubation period

Benjumea,

Navarro,

Alonso-Tarrés

2024

Journal of Medical Microbiology

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Introduction. The absence of a gold-standard methodology for the microbiological diagnosis of urinary tract infections (UTI) has led to insufficient standardization of criteria for the interpretation of results and processing methods, particularly incubation time and culture media. Hypothesis. 48-hour incubation time period and use of blood agar enhances the sensitivity of microorganisms isolated significantly. Aim. To determine the sensitivity of blood agar and Brilliance UTI chromogenic agar, incubating for different periods (24–48 hours), for the detection of positive urine cultures. Methodoloy. Comparisons were made between all possible combinations of media and incubation times. As the gold-standard reference, we used the routine methodology of our laboratory, which involves prior screening with available clinical data, flow cytometry, sediment analysis and/or Gram staining. Screened samples were then cultured on blood agar and chromogenic agar and incubated for 48 hours. Also, based on the results of Gram staining, additional media were added in selected cases. Results. The most significant difference was found between chromogenic agar incubated for 24 hours and blood agar incubated for 48 hours, with the latter method allowing the recovery of 10.14 % more microorganisms (P < 0.0001). Furthermore, the value of performing Gram staining to guide processing was demonstrated, as it avoided the loss of at least 5.14 % of isolates. Conclusions. At least in urological and nephrological patients it is essential to include enriched culture media (blood agar) or to extend the incubation times due to the improvement of the diagnostic sensitivity of urine cultures. Gram staining also can help detect the presence of fastidious microorganisms or mixed infections, indicating whether rich and/or selective media should be included to enhance the diagnostic sensitivity of cultures. If this methodology is not followed, it should be noted that besides fastidious species, fastidious strains of Escherichia coli, Proteus mirabilis, Pseudomonas aerugniosa and Stenotrophomonas maltophilia will also be missed.

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Prediction of urine culture results by automated urinalysis with digital flow morphology analysis

Cited by 4 publications

References 22 publications

A novel approach to screening and managing the urinary tract infections suspected sample in the general human population

A novel approach to screening and managing the urinary tract infections suspected sample in the general human population

Correlation between Hematologic Parameters and Asymptomatic Bacteriuria in the Full-Term Pregnant Patients in Dr. Kariadi Hospital, Semarang, Indonesia

Improving the diagnosis of urinary tract infections by the use of enriched media and a 48-hour incubation period

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