Point-of-care urine culture for managing urinary tract infection in primary care: a randomised controlled trial of clinical and cost-effectiveness

Abstract

Point-of-care urine culture was not effective when used mainly to adjust immediate antibiotic prescriptions. Further research should evaluate use of the test to guide initiation of 'delayed antibiotics'.

Diagnosis and Management of UTI in Primary Care Settings—A Qualitative Study to Inform a Diagnostic Quick Reference Tool for Women Under 65 Years

“…To improve public awareness, antibiotic campaigns and patient-facing leaflets could use language more inclusive of non-respiratory infections such as UTIs and highlight the benefits of back-up antibiotics. Continued effort should be put in to development of a more accurate point-of-care test that can more accurately guide the need for and choice of antibiotic [ 42 ].…”

A new point-of-care test for the rapid detection of urinary tract infections

“…As a whole, results obtained in this study have highlighted the robustness of the MBS POCT for the detection of suspected UTIs and suggest how its rapidity, simplicity, and user-friendliness could represent key advantages for the clinical management of patients before a UTI is confirmed by culture-based laboratory methods. By comparison with available devices for UTI detection [33][34][35][36][37], it appears that the MBS POCT could place well among other culture-based devices thanks to its ability to combine short analytical time and high accuracy.…”

Digital dipstick: miniaturized bacteria detection and digital quantification for the point-of-care

“…30 Bacterial growth increases the amount of enzyme and thus amplifies the color signal. Negative wells (wells without CFU) Method Validity Time to result Required operator skills Complexity/cost Urine culture 19 Gold standard 24-72 h Trained High Flexicult (culture based) 17,20 >90% 24 h Trained High Nitride dipsticks 23,24 40-70% 2-5 min Untrained Low Dip-slide (culture based) 21 remain uncolored. The color versus no color difference of the wells forms a digital signal, and simple counting of colored wells by the naked eye or cellphone camera allows quantifying the bacterial concentration via the most probable number method.…”

“…[3][4][5]8,10,[12][13][14]16 The resulting cost of testing and the need for trained personnel have limited the translation of digital assays to the point-of-care (PoC) setting for common infectious diseases like urinary tract infections (UTIs). 17,18 Today's gold standard diagnostic test for UTI detection is culture-based phenotypic testing, 19 which takes 1-3 days and requires trained personnel and laboratory facilities. Other diagnostic formats for the detection of UTIs include culturebased assays (Flexicult, 17,20 dip-slides 21,22 ), nitride sticks, 23,24 nucleic acid based tests (PCR, 25 LAMP 5 ), immunoassays, [26][27][28][29] and single cell imaging based tests.…”

“…17,18 Today's gold standard diagnostic test for UTI detection is culture-based phenotypic testing, 19 which takes 1-3 days and requires trained personnel and laboratory facilities. Other diagnostic formats for the detection of UTIs include culturebased assays (Flexicult, 17,20 dip-slides 21,22 ), nitride sticks, 23,24 nucleic acid based tests (PCR, 25 LAMP 5 ), immunoassays, [26][27][28][29] and single cell imaging based tests. 9 These tests are limited by their need for operation by trained personnel, lab facilities or readout instruments that add cost and complexity, or suffer from high rates of false negative results (Table 1).…”