Research on antimicrobial residues activity in urine samples of hospitalized patients

Abstract

Introduction: Urinary tract infection is quite frequent in a hospital environment, and the urine culture is the gold standard for diagnosis of this disease, because it allows bacterial identification and performing antimicrobial susceptibility testing. Culturenegative urine samples result of patients with strong suspicion of infection may occur due to the activity of antimicrobial residues, which can interfere with bacterial growth in vitro and produce false-negative results. Objective: Verify the occurrence of falsenegative urine cultures due to the presence of antimicrobial residues in samples of patients admitted to the Clinical Hospital of Paraná Federal University. Material and methods: A total of 188 urine samples from hospitalized patients were randomly selected, during the period from July to December 2012. All samples were evaluated on the result of the urine culture, bacteriuria, and research on residues of antimicrobial activity by manual and automated techniques. Results: 44 (23.4%) presented positive urine culture, 121 (64.4%) negative urine culture, and 23 (12.2%) presented growth of many species. In 14 samples, negative urine cultures associated with the presence of bacteria and were positive for the research on antimicrobial residues activity (RARA), were observed. Conclusion: Automated technique showed better performance when compared to manual technique, with sensitivity of 92.8% and 71.4%, respectively. The presence of antimicrobial residues may affect the recovery of bacteria in the urine, producing a false-negative result.

Antibiotic Screening of Urine Culture for Internal Quality Audit at Amrita Hospital, Kochi

“…He also states the presence of urine antimicrobial activity as a reason for identification of sterile pyuria in a number of urine specimens [10]. Cardozo D et al, state that in their study on antimicrobial residue activity in urine, 14/188 urine specimens yielded no bacteria on culture but were positive for antimicrobial residue activity [11]. Organisms most commonly detected in our study were E. coli, Klebsiella, Pseudomonas and Enterococcus.…”