Sysmex UF-1000i flow cytometer to screen urinary tract infections: the URISCAM multicentre study

Wong

et al. 2019

IAD

136

Background: Urinary Tract Infection (UTI) is a common infection in children. Prompt diagnosis and appropriate treatment are very important to reduce the morbidity associated with this condition. Objective: To provide an update on the evaluation, diagnosis, and treatment of urinary tract infection in children. Methods: A PubMed search was completed in clinical queries using the key terms “urinary tract infection”, "pyelonephritis" OR "cystitis". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English literature and the pediatric age group. Patents were searched using the key terms “urinary tract infection” "pyelonephritis" OR "cystitis" from www.google.com/patents, http://espacenet.com, and www.freepatentsonline.com. Results: Escherichia coli accounts for 80 to 90% of UTI in children. The symptoms and signs are nonspecific throughout infancy. Unexplained fever is the most common symptom of UTI during the first two years of life. After the second year of life, symptoms and signs of pyelonephritis include fever, chills, rigor, flank pain, and costovertebral angle tenderness. Lower tract symptoms and signs include suprapubic pain, dysuria, urinary frequency, urgency, cloudy urine, malodorous urine, and suprapubic tenderness. A urinalysis and urine culture should be performed when UTI is suspected. In the work-up of children with UTI, physicians must judiciously utilize imaging studies to minimize exposure of children to radiation. While waiting for the culture results, prompt antibiotic therapy is indicated for symptomatic UTI based on clinical findings and positive urinalysis to eradicate the infection and improve clinical outcome. The choice of antibiotics should take into consideration local data on antibiotic resistance patterns. Recent patents related to the management of UTI are discussed. Conclusion: Currently, a second or third generation cephalosporin and amoxicillin-clavulanate are drugs of choice in the treatment of acute uncomplicated UTI. Parenteral antibiotic therapy is recommended for infants ≤ 2 months and any child who is toxic-looking, hemodynamically unstable, immunocompromised, unable to tolerate oral medication, or not responding to oral medication. A combination of intravenous ampicillin and intravenous/intramuscular gentamycin or a third-generation cephalosporin can be used in those situations. Routine antimicrobial prophylaxis is rarely justified, but continuous antimicrobial prophylaxis should be considered for children with frequent febrile UTI.

Section: Current and Future Developmentsmentioning

confidence: 99%

Section: Current and Future Developmentsmentioning

confidence: 99%

Urinary Tract Infection in Children

Wong

et al. 2019

IAD

136

“…Yeast-like cell counting (YLCC) is a parameter of automatic urinalysis system, which is shown as a reliable application for fungal detection in urine in several studies. [10][11][12] Our previous work showed that YLCC is suitable for identifying urines with relatively high Candida CFUs. 13 YLCCpositive urinalysis could imply candiduria prior to urine culture, especially the persistent positive YLCC cases.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Novel Laboratory Candiduria Screening Protocol in the Intensive Care Unit

He¹,

Su²,

Bi³

et al. 2021

IDR

Background: Since urine cultures are only guaranteed for patients with obvious urinary symptoms in most cases, most of candiduria episodes are ignored in clinic. Objective: This study aimed to design a screening protocol to improve diagnostic efficiency of candiduria, and provide information of Candida species and drug susceptibility. Methods: All patients, who were admitted to the intensive care unit (ICU) of our hospital during December 1, 2018 and October 1, 2019, were enrolled in this study. Urinalysis was performed every three days for each subject from the first day of ICU admission. Urine specimens were sampled for fungal culture with either condition: (1) yeast-like cell counting (YLCC) ≥200; (2) positive YLCCs were observed in two consecutive tests, and at least one YLCC ≥100. Results: The screening protocol dramatically improved the candiduria diagnostic rate of ICU patients from 2.28% to 17.27%. However, compared to the historical control, the screening protocol has no time-saving advantage in candiduria diagnosing. Higher percentage of C. albicans in screening protocol-identified candiduria patients was observed, although there was no statistical difference. Our results indicated that female gender, pneumonia, diabetes and infarction/hemorrhage patients were more prone to develop candiduria. Non-candiduria patients showed a better tendency for survival and shorter ICU stay length. Multisite colonization was common in the surveyed candiduria patients, who were up to 70.83% showed Candida positive cultures in sputum. Conclusion: The screening protocol established in the study was a convenient and practical tool for early warning and feasible management of candiduria and IC.

“…The percentages used for the different scenarios ( Fig. 1) were taken from the data obtained in two previously published studies [19,20].…”

Section: Model Descriptionmentioning

confidence: 99%

Cost Analysis of the Automated Examination of Urine with the Sysmex UN-Series™ in a Spanish Population

Carrera¹,

Bueno²

2020

PharmacoEconomics Open

Background Current practice for urinalysis mainly entails different manual or semi-automated procedures that generate substantial financial costs, as well as a high and time-consuming workload for laboratory personnel. Objective The aim of this study was to assess whether the availability of integrated and fully automated urinalysis systems such as the UN-Series™ from Sysmex could resolve such concerns. Methods The target population was established based on 92,459 urine samples, which is the total average number of urine samples collected in the clinical and microbiology laboratory department of La Mancha Centro Hospital over a 10-year period (2008-2018). Financial data were retrieved from the eSalud database. Reference and test scenarios were defined based on clinical features found in reports from public websites. The cost and savings analyses were based on total costs over a 1-year time frame for the reference and test scenarios. The total average annual time savings for laboratory personnel were also calculated. Results The comparison of annual costs for current practice versus the automated examination of urine samples found average cost savings of €340,003 per year. Assessment of body fluids using the automated analysis system would provide average annual savings of €1063. The use of the UN-Series™ would save 1615 h annually for laboratory personnel. Conclusion Implementing the UN-Series™ for the automated analysis of urine samples within routine practice in clinical laboratories could minimise costs, provide substantial savings for investment and improve laboratory procedures. Furthermore, the UN-Series™ could contribute to synergy between clinical analysis and microbiology laboratories in Spain.