Urinary tract infections caused by anaerobic bacteria. Utility of anaerobic urine culture

Legaria, María C.; Barberis, Claudia; Famiglietti, A.; Gregorio, S. De; Stecher, Daniel; Rodríguez, Carlos Hernán; Vay, Carlos

doi:10.1016/j.anaerobe.2022.102636

Cited by 4 publications

(8 citation statements)

References 83 publications

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“…Sterile pyuria (without bacteriuria) was found in 9% of patients with lower urinary tract symptoms and suspected UTI presenting at the general practitioners' office and might be caused by non‐infectious etiologies 18 . Another important cause of pyuria without growth on standard cultivation media is anaerobes, especially in patients with underlying illness such as diabetes or urinary tract abnormalities 19,20 . Pyuria without culture growth in our study might also be caused by previous antibiotic treatment or by the presence of slow‐growing or fastidious bacteria that did not grow using our diagnostic routine.…”

Section: Discussionmentioning

confidence: 64%

“…18 Another important cause of pyuria without growth on standard cultivation media is anaerobes, especially in patients with underlying illness such as diabetes or urinary tract abnormalities. 19,20 Pyuria without culture growth in our study might also be caused by previous antibiotic treatment or by the presence of slow-growing or fastidious bacteria that did not grow using our diagnostic routine. Inversely, 19% (3548/18536) of urine cultures with uropathogens had a WBC count <50/μL.…”

Section: Discussionmentioning

confidence: 72%

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Using the Sysmex UF‐4000 urine flow cytometer for rapid diagnosis of urinary tract infection in the clinical microbiological laboratory

Korsten,

de Gier,

Leenders

et al. 2024

Clinical Laboratory Analysis

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BackgroundUrinary tract infections are responsible for a significant worldwide disease burden. Performing urine culture is time consuming and labor intensive. Urine flow cytometry might provide a quick and reliable method to screen for urinary tract infection.MethodsWe analyzed routinely collected urine samples received between 2020 and 2022 from both inpatients and outpatients. The UF‐4000 urine flow cytometer was implemented with an optimal threshold for positivity of ≥100 bacteria/μL. We thereafter validated the prognostic value to detect the presence of urinary tract infection (UTI) based on bacterial (BACT), leukocyte (WBC), and yeast‐like cell (YLC) counts combined with the bacterial morphology (UF gram‐flag).ResultsIn the first phase, in 2019, the UF‐4000 was implemented using 970 urine samples. In the second phase, between 2020 and 2022, the validation was performed in 42,958 midstream urine samples. The UF‐4000 screen resulted in a 37% (n = 15,895) decrease in performed urine cultures. Uropathogens were identified in 18,673 (69%) positively flagged urine samples. BACT > 10.000/μL combined with a gram‐negative flag had a >90% positive predictive value for the presence of gram‐negative uropathogens. The absence of gram‐positive flag or YLC had high negative predictive values (99% and >99%, respectively) and are, therefore, best used to rule out the presence of gram‐positive bacteria or yeast. WBC counts did not add to the prediction of uropathogens.ConclusionImplementation of the UF‐4000 in routine practice decreased the number of cultured urine samples by 37%. Bacterial cell counts were highly predictive for the presence of UTI, especially when combined with the presence of a gram‐negative flag.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 72%

Using the Sysmex UF‐4000 urine flow cytometer for rapid diagnosis of urinary tract infection in the clinical microbiological laboratory

Korsten,

de Gier,

Leenders

et al. 2024

Clinical Laboratory Analysis

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“…Here, Gram staining of urine specimen showed numerous typical Y-branched GPRs; however, no growth was observed in the routine urine culture. Anaerobic urine culture should be considered in patients with an immunocompromised state, urological problems and positive Gram staining but negative routine culture [ 24 ]. If Bifidobacterium spp.…”

Section: Discussionmentioning

confidence: 99%

Bacteraemia and obstructive pyelonephritis caused by Bifidobacterium breve in an elderly woman: a case report and literature review

Nishio,

Morioka,

Takai

et al. 2023

Access Microbiology

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Bifidobacterium spp. are non-spore-forming Gram-positive anaerobes that are indigenous to the human gastrointestinal tract and vagina. They are believed to be non-pathogenic organisms for humans and thus are widely used as probiotics. An 83-year-old woman taking cephalexin for 4 days was diagnosed with obstructive pyelonephritis. Y-branched Gram-positive rods were found in both anaerobic and aerobic blood culture bottles, and in an anaerobic urine culture. Bifidobacterium breve was finally identified. Ceftriaxone and metronidazole were administered to the patient, and she was discharged after intermittent catheterization for dysuria. Urinary tract infection caused by Bifidobacterium spp. is believed to be rare, but it can develop in patients with underlying urological conditions. Recognition of the characteristic morphology and conducting anaerobic urine culture may help in identifying more cases of Bifidobacterium urinary tract infections.

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“…Traditionally, anaerobes have not been considered to be uropathogenic (25,26). However, in this age of metagenomics, metaculturomics, and MALDI-TOF identification, this dogma is being reexamined (27). The concept that oxygen is toxic to obligate anaerobes (28) does not account for the strategies these microbes use to survive and flourish in human organ niches (29,30), including the urinary tract.…”

Section: Statement Of Purposementioning

confidence: 99%

“…Finally, some urinary microbes have no cell wall, most notably Mycoplasma and Ureaplasma (36). While specialized techniques exist for the culture of these microbes (27,37,38) and rapid molecular diagnoses have been reported for both (39), we will not review these organisms here. For recent reviews on the taxa mentioned above, see (24,(40)(41)(42)(43)(44)(45)(46).…”

Section: Statement Of Purposementioning

confidence: 99%

Beyond the usual suspects: emerging uropathogens in the microbiome age

Moreland,

Choi,

Geaman

et al. 2023

Front. Urol.

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The advent of sensitive enhanced culture (metaculturomic) and culture-independent DNA-based (metagenomic) methods has revealed a rich collection of microbial species that inhabit the human urinary tract. Known as the urinary microbiome, this community of microbes consists of hundreds of distinct species that range across the entire phylogenetic spectrum. This new knowledge clashes with standard clinical microbiology laboratory methods, established more than 60 years ago, that focus attention on a relatively small subset of universally acknowledged uropathogens. Increasing reports support the hypothesis that this focus is too narrow. Single uropathogen reports are common in women with recurrent urinary tract infection (UTI), although wider disruption of their urinary microbiome is likely. Typical “UTI” symptoms occur in patients with “no growth” reported from standard culture and sometimes antibiotics improve these symptoms. Metaculturomic and metagenomic methods have repeatedly detected fastidious, slow growing, and/or anaerobic microbes that are not detected by the standard test in urine samples of patients with lower urinary tract symptoms. Many of these microbes are also detected in serious non-urinary tract infections, providing evidence that they can be opportunistic pathogens. In this review, we present a set of poorly understood, emerging, and suspected uropathogens. The goal is to stimulate research into the biology of these microbes with a focus on their life as commensals and their transition into pathogens

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Urinary tract infections caused by anaerobic bacteria. Utility of anaerobic urine culture

Cited by 4 publications

References 83 publications

Using the Sysmex UF‐4000 urine flow cytometer for rapid diagnosis of urinary tract infection in the clinical microbiological laboratory

Using the Sysmex UF‐4000 urine flow cytometer for rapid diagnosis of urinary tract infection in the clinical microbiological laboratory

Bacteraemia and obstructive pyelonephritis caused by Bifidobacterium breve in an elderly woman: a case report and literature review

Beyond the usual suspects: emerging uropathogens in the microbiome age

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