UriSed as a screening tool for presumptive diagnosis of urinary tract infection

Martínez, Marlene; Bottini, P.V.; Levy, Carlos Emílio; Garlipp, Célia Regina

doi:10.1016/j.cca.2013.07.020

Cited by 13 publications

(9 citation statements)

References 13 publications

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“…A reduction of one-third is similar to the saving rates that other working groups have recently published. However, this work was done almost exclusively with the flow cytometers of the Sysmex UF series (6,7,9,10,15,16), and in many of these studies, which were mostly conducted in hospital surroundings (9,12,15,16,20), the prevalence of UTIs was in the range of 13 to 30% (8-11, 13, 15, 16). Our trial gives strong evidence that automated urine microscopy not only works in the setting of a hospital laboratory but is also a valuable tool in the nonhospital laboratory, delivering fast screening results to general practitioners.…”

Section: Discussionmentioning

confidence: 99%

“…Urine culture was performed on the second aliquot by plating 10 l of the sample on Columbia blood agar containing colistin-nalidixic acid and on chromogenic agar, the latter for growth assessment of gram-negative bacteria by color changes (Urin 3G-Agar II biplates, heipha Dr. Müller GmbH, Eppelheim, Germany). The plates were incubated under aerobic conditions at 36°C for 16 to 18 h. For the purpose of this study, we considered a culture positive if it contained one or two potential uropathogens at a concentration of Ն10 4 CFU/ml as suggested by several authors (7,15,16). Potential uropathogens were defined as members of the family Enterobacteriaceae, Enterococcus species, Streptococcus agalactiae, Pseudomonas species, Candida species, Staphylococcus aureus, and non-S. aureus species.…”

Section: Methodsmentioning

confidence: 99%

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Detection of Significant Bacteriuria by Use of the iQ200 Automated Urine Microscope

Stürenburg¹,

Kramer²,

Schön

et al. 2014

J Clin Microbiol

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cIn the microbiology laboratory, there is an augmented need for rapid screening methods for the detection of bacteria in urine samples, since about two-thirds of these samples will not yield any bacteria or will yield insignificant growth when cultured. Thus, a reliable screening method can free up laboratory resources and can speed up the reporting of a negative urine result. In this study, we have evaluated the detection of leukocytes, bacteria, and a new sediment indicator, the "all small particles" (ASP), by an automated instrument, the iQ200 urine analyzer, to detect negative urine samples that can be excluded from culture. A coupled automated strip reader (iChem Velocity), enabling the detection of nitrite and leukocyte esterase, was tested in parallel. In total, 963 urine samples were processed through both conventional urine culture and the iQ200/iChem Velocity workstation. Using the data, a multivariate regression model was established, and the predicted specificity and the possible reduction in urine cultures were calculated for the indicators and their respective combinations (leukocytes plus bacteria plus ASP and leukocyte esterase plus nitrite). Among all options, diagnostic performance was best using the whole microscopic content of the sample (leukocytes plus bacteria plus ASP). By using a cutoff value of >10 4 CFU/ml for defining a positive culture, a given sensitivity of 95% resulted in a specificity of 61% and a reduction in urine cultures of 35%. By considering the indicators alone, specificity and the culture savings were both much less satisfactory. The regression model was also used to determine possible cutoff values for running the instrument as part of daily routine. By using a graphical representation of all combinations possible, we derived cutoff values for leukocyte, bacterial, and ASP count, which should enable the iQ200 microscope to screen out approximately one-third of the urine samples, significantly reducing the workload in the microbiology laboratory.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Detection of Significant Bacteriuria by Use of the iQ200 Automated Urine Microscope

Stürenburg¹,

Kramer²,

Schön

et al. 2014

J Clin Microbiol

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“…In studies comparing different instruments with different methods with the gold standard manual microscopy, both Lamchiagdhase et al ( 6 ) and Alves et al ( 7 ) have reported fair agreement in yeast parameter. Studies on the performance of UriSed ® are not many ( 2 , 3 , 11 , 13 – 16 ). For practical reasons they focus on parameters like red blood cells, white blood cells or epithelial cells.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies compared automated analysis systems with manual microscopy ( 1 – 11 ) and most recognized the accuracy and precision of automated systems, as well as their feasibility as routine screening tools ( 1 , 3 , 6 , 9 ). For practical reasons these studies spare more effort on parameters like red blood cells, white blood cells, and epithelial cells.…”

Section: Introductionmentioning

confidence: 99%

High False Positives and False Negatives in Yeast Parameter in an Automated Urine Sediment Analyzer / Brojni Lažno Pozitivni I Lažno Negativni Rezultati Za Parametar Gljivice Na Automatskom Analizatoru Urina

Aydın

Elli̇dağ

Eren³

et al. 2015

Journal of Medical Biochemistry

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SummaryBackgroundAutomated urine sediment analyzers have proven their feasibility in medical laboratories. However, editing manual microscopic review of some specimens severely limits the usefulness of such systems. This study aims to give feedback on the practical experience on »Yeast«, which is one of the parameters that compel frequent manual reviews.Methods5448 freshly collected urine specimens submitted from various departments of our hospital for diagnostic urinalysis were studied by the UriSed® (77 Elektronika, Hungary). A specialist medical doctor inspected every image on-board, and reviewed the ones with a »Yeast« alarm by traditional manual microscopy.ResultsUriSed alarmed in 491 samples (9%) for yeast. In 59 samples (1%) the number of particles exceeded the cut-off and a »positive for yeast« was set. A false positive report of yeast +1 to 3+/HPF was found in 51 samples (0.9%). There were 8 cases with positive for yeast from both microscopic methods. Thirty-three »negative for yeast« samples were corrected as positive after the manual microscopic review.ConclusionsWe report a high percentage of false positives and negatives in the yeast parameter, in line with other studies on UriSed as well as on other instruments in the market. As an important feedback, our observations showed that the major concern in false results was »the focusing problem«. We believe in the necessity of a focus check and comparison of alarms between images on board.

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“…Urine sediment analysis by manual microscopy is an efficient screening method but suffers from interobserver variability and is labor-intensive [8]. Automated microscopy is extensively used for urine sediment analysis and has recently been evaluated for bacteriological screening of urine samples, with high accuracy in terms of sensitivity and negative predictive value (NPV) [3910]. Additionally, as compared with urine culture, it shortens the turnaround time of analysis, and may reduce both workload and laboratory costs [9].…”

Section: Introductionmentioning

confidence: 99%

Performance of the cobas u 701 Analyzer in Urinary Tract Infection Screening

et al. 2019

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Background Negative urine cultures to rule out urinary tract infections (UTI) generate a considerable laboratory workload; thus, a rapid screening test is desirable. We evaluated the performance of a new automated microscopy analyzer, cobas u 701 (Roche Diagnostics International, Rotkreuz, Switzerland) for the screening of UTI, and developed a rule-out strategy to reduce the number of samples requiring culture. We also assessed squamous epithelial cell (SEC) count as a predictor of culture contamination. Methods In total, 1,604 urine samples from outpatients were analyzed with cobas u 701 and culture. Bacterial (BAC) and white blood cell (WBC) counts were used for sample interpretation. To determine a useful cut-off point to predict negative cultures, we selected the highest sensitivity and specificity values obtained from ROC curves. Diagnostic accuracy by age and gender was evaluated. Results Urine culture showed growth of ≥10 4 colony forming units (CFU)/mL in 256 samples (16.0%). The highest sensitivity (91.8%) and specificity (68.4%) were obtained for cut-off points of 119 BAC/µL and 22 WBC/µL. The combination of BAC and WBC improved the performance of the rule-out strategy with a low rate of false-negative results (1.5%) and a high negative predictive value (NPV, 97.3%). Fifty-seven percent of the samples would not have required culture. SEC count was a poor predictor of culture contamination. Conclusions cobas u 701 can substantially reduce the number of urine samples requiring culture, with a low false-negative rate and a high NPV.

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UriSed as a screening tool for presumptive diagnosis of urinary tract infection

Cited by 13 publications

References 13 publications

Detection of Significant Bacteriuria by Use of the iQ200 Automated Urine Microscope

Detection of Significant Bacteriuria by Use of the iQ200 Automated Urine Microscope

High False Positives and False Negatives in Yeast Parameter in an Automated Urine Sediment Analyzer / Brojni Lažno Pozitivni I Lažno Negativni Rezultati Za Parametar Gljivice Na Automatskom Analizatoru Urina

Performance of the cobas u 701 Analyzer in Urinary Tract Infection Screening

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