Validation and Search of the Ideal Cut-Off of the Sysmex UF-1000i® Flow Cytometer for the Diagnosis of Urinary Tract Infection in a Tertiary Hospital in Spain

Millán-Lou, María Isabel; García-Lechuz, J.M.; Ruiz-Andrés, María Angeles; López, Concepción; Aldea, María José; Revillo, María José; Rezusta, Antonio

doi:10.3389/fmed.2018.00092

Cited by 9 publications

(10 citation statements)

References 32 publications

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“…Overall performance of automated urinalysis by the UF-1000i, based on AUC values, was better for men compared to women for both leucocyte and bacterial count. The few other studies focusing on genderspecific performance of the UF-1000i reported this as well [17][18][19]. Compared to these studies, our leucocyte AUC values were similar (reported range: men 0.876-0.950, women 0.798-0.937), while our bacterial AUC values were somewhat lower (reported range: men 0.956-0.990, women 0.930-0.946).…”

Section: Discussionsupporting

confidence: 78%

“…In general, our gender-specific leucocyte cut-off values were somewhat higher (men 60/µL, women 43/µL) compared to other studies (men 3.9-52.1/µL, women 3.8-31.5/µL). The bacterial cut-offs (men 75/µL, women 139/µL) were within the reported range (men 31.3-240.5/µL, women 95-689.0/µL) [17][18][19]. It is important to realize that these studies used positive UC as definition of UTI, were not situated in an ED setting, and used different sensitivities to determine the cut-off values.…”

Section: Discussionmentioning

confidence: 86%

“…adequately analysed in the ED setting. Most gender-related studies are situated in the primary care, patient populations are insufficiently described and comparison between genders is lacking [10][11][12][13][14][15][16][17][18][19]. In addition, in contrast to the ED, the majority of cases in the primary care setting are women [3,20].…”

Section: Introductionmentioning

confidence: 99%

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Influence of gender on the performance of urine dipstick and automated urinalysis in the diagnosis of urinary tract infections at the emergency department

Middelkoop

Pelt

Kampinga

et al. 2021

European Journal of Internal Medicine

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Background: Urinary tract infections (UTIs) are frequently encountered at the Emergency Department (ED). Given the anatomical differences between men and women, we aimed to clarify differences in the diagnostic performance of urinary parameters at the ED. Methods: A cohort study of adults presenting at the ED with fever and/or clinical suspected UTI. Performance of urine dipstick (UD) and automated urinalysis (UF-1000i) were analysed for the total study population and men and women separately. We focused on 1) UTI diagnosis and 2) positive urine culture (UC, ≥10 5 CFU/ml) as outcome.Results: In 360 of 917 cases (39.3%) UTI was established (men/women 35.1%/43.6%). Diagnostic accuracy of UD was around 10% lower in women compared to men. Median automated leucocyte and bacterial count were higher in women compared to men. Diagnostic performance by receiver operating analysis was 0.851 for leucocytes (men/women 0.879/0.817) and 0.850 for bacteria (men/women 0.898/0.791). At 90% sensitivity, cutoff values of leucocyte count (men 60/µL, women 43/µL), and bacterial count (men 75/µL, women 139/µL) showed performance differences in favour of men. In both men and women, diagnostic performance using specified cut-off values was not different between normal and non-normal bladder evacuation. UC was positive in 327 cases (men/women 149/178), as with UTI diagnosis, diagnostic values in men outperformed women. Conclusions: Overall diagnostic accuracy of urinary parameters for diagnosing UTI is higher in men. The described differences in cut-off values for leukocyte and bacterial counts for diagnosing UTI necessitates genderspecific cut-off values, probably reflecting the influence of anatomical and urogenital differences.A suspected UTI is a frequently encountered condition at the Emergency Department (ED). Patients presenting at the ED are hardly comparable with primary care patients. In an ED setting, the majority of the patients have a complicated UTI (based on functional or structural abnormalities of the genitourinary tract, instrumentation of the urinary tract or antibiotic use) which will influence the performance of diagnostic tests. The influence of gender on the performance of urinary diagnostics, like urine dipstick (UD) and automated urinalysis, is not

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 86%

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Influence of gender on the performance of urine dipstick and automated urinalysis in the diagnosis of urinary tract infections at the emergency department

Middelkoop

Pelt

Kampinga

et al. 2021

European Journal of Internal Medicine

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“…According to the reviewed literature, the cut-off values used range from 25 to 230 bacteria/μL (2, 12, 18, 21–23). In our study, the best cut-off point was found after comparing the results of culture and bacterial or leukocyte count, and it was 138 bacteria/μL or 119.8 leukocyte/μL (SE 95.3%, SP 70.4%) with the UF-1000i (24). This cut-off value had a similar SE and a higher SP than the cut-off point obtained with the FUS200 (5.7 bacteria/μL or 4.3 leukocyte/μL; 95.8% SE, 44.4% SP) (Table 2).…”

Section: Discussionmentioning

confidence: 71%

Comparing Two Automated Techniques for the Primary Screening-Out of Urine Culture

et al. 2018

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Urinary tract infection is the most common human infection with a high morbidity. In primary care and hospital services, conventional urine culture is a key part of infection diagnosis but results take at least 24 h. Therefore, a rapid and reliable screening method is still needed to discard negative samples as quickly as possible and to reduce the laboratory workload. In this aspect, this study aims to compare the diagnostic performance between Sysmex UF-1000i and FUS200 systems in comparison to urine culture as the gold standard. From March to June 2016, 1,220 urine samples collected at the clinical microbiology laboratory of the “Miguel Servet” hospital were studied in parallel with both analysers, and some technical features were evaluated to select the ideal equipment. The most balanced cut-off values taking into account bacteria or leukocyte counts were 138 bacteria/μL or 119.8 leukocyte/μL for the UF-1000i (95.3% SE and 70.4% SP), and 5.7 bacteria/μL or 4.3 leukocyte/μL for the FUS200 (95.8% SE and 44.4% SP). The reduction of cultured plates was 37.4% with the FUS200 and 58.3% with the UF-1000i. This study shows that both techniques improve the workflow in the laboratory, but the UF-1000i has the highest specificity at any sensitivity and the FUS200 needs a shorter processing time.

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“…Flow cytometry analysis is capable of identifying bacteria, and the Sysmex UF-1000i (Sysmex, Kobe, Japan) flow cytometer has been developed to standardize urine analyses [7]. This system can analyze urine particles rapidly, such as white blood cells (WBC), red blood cells (RBC), bacteria, epithelial cells, and casts effectively and reliably.…”

mentioning

confidence: 99%

Performance of the Sysmex UF-1000i System in Screening for Significant Bacteriuria in Patients with Bladder Cancer Who Received Bacillus Calmette-Guérin Treatment

Kim

Jung

Kim

et al. 2020

Urogenit Tract Infect

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Purpose: Diagnosing urinary tract infections by urine culture is time-consuming during a Bacillus Calmette-Guérin treatment. Because the urine culture results take time to collect, patients are treated presumptively, or Bacillus Calmette-Guérin is discontinued before the results. This study evaluated the ability of the Sysmex UF-1000i system to examine the urine bacterial count and determine if it could be used to predict a positive culture. Materials and Methods: 180 patients who underwent transurethral resection for bladder tumors and received intravesical Bacillus Calmette-Guérin treatment between January 2017 and July 2018 were evaluated prospectively. For patients who received an intravesical Bacillus Calmette-Guérin treatment, urine flow cytometry, and urine cultures were assessed weekly during the treatment period. Results: During Bacillus Calmette-Guérin instillation, 44, 146, and 27 patients had bacteriuria, pyuria, and positive urine nitrite, respectively. Multivariate analysis indicated that the predictors associated with bacteriuria included the urine flow cytometry results of ＞100 bacteria/l (odds ratio, 22.73; p＜0.001) and positive urine nitrite (odds ratio, 5.67; p=0.012) at the time of sampling for positive urine culture. The area under the receiver operative characteristic curve for diagnosing bacteriuria by urine flow cytometry was 0.825. A urine flow cytometry cutoff value of ＞100 bacteria/l resulted in a sensitivity and specificity of 75% and 90.91%, respectively. Using the cutoff of ＞1,000 bacteria/l, the sensitivity and specificity were 50% and 94.85%, respectively. Conclusions: Rapid urinary tract infection diagnosis using Sysmex UF-1000i can be used to determine whether to treat an infection and to avoid unnecessary Bacillus Calmette-Guérin discontinuation and urine culture tests.

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Validation and Search of the Ideal Cut-Off of the Sysmex UF-1000i® Flow Cytometer for the Diagnosis of Urinary Tract Infection in a Tertiary Hospital in Spain

Cited by 9 publications

References 32 publications

Influence of gender on the performance of urine dipstick and automated urinalysis in the diagnosis of urinary tract infections at the emergency department

Influence of gender on the performance of urine dipstick and automated urinalysis in the diagnosis of urinary tract infections at the emergency department

Comparing Two Automated Techniques for the Primary Screening-Out of Urine Culture

Performance of the Sysmex UF-1000i System in Screening for Significant Bacteriuria in Patients with Bladder Cancer Who Received Bacillus Calmette-Guérin Treatment

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