Advertisement

Urine Flow Cytometry in the Diagnosis of Urinary Tract Infection

Original Article

Abstract

Objectives

To determine the cut-off value of bacteria with urine flow cytometer in diagnosing urinary tract infection.

Methods

From a total of 546 patients admitted to the hospital with urinary tract infection (UTI), two urine samples were obtained for each patient. Urine samples in sterile containers were divided into two; first for urine culture and second for simultaneous measurement with UF-1000i flow cytometry device. The presence of a single type of bacteria over 103 CFU/mL in urine culture was accepted as UTI.

Results

Of 546 patients, 210 (38.5%) were boys and 336 (61.5%) were girls. There was no growth in 489 (89.5%) of the urine specimens and 57 (10.4%) samples showed growth (>103 CFU/ml). A threshold of 10 bacteria/μL in flow cytometry (sensitivity = 100%) showed the best compatibility with culture. Diagnostic values in terms of sensitivity (100%), specificity (43.5%), negative predictive value (100%) and positive predictive value (17.7%) were satisfactory.

Conclusions

The UF-1000i flow cytometer can give results quickly and exclude UTI using the determined number of cut-off bacteria at low cost. Thus, if Sysmex UF-1000i is used, quick and accurate results can be obtained and unnecessary laboratory tests can be prevented. Also, patient convenience can be increased.

Keywords

Child Flow cytometry Urinary tract infections 

Notes

Contributions

SM: Conception and design, acquisition of data, analysis and interpretation of data; SC: Writing of the manuscript. SM will act as guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest

None.

References

  1. 1.
    Spencer JD, Schwaderer A, McHugh K, Hains DS. Pediatric urinary tract infections: an analysis of hospitalizations, charges, and costs in the USA. Pediatr Nephrol. 2010;25:2469–75.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Montini G, Tullus K, Hewitt I. Febrile urinary tract infections in children. N Engl J Med. 2011;365:239–50.CrossRefPubMedGoogle Scholar
  3. 3.
    Hellstrom A, Hanson E, Hansson S, Hjalmas K, Jodal U. Association between urinary symptoms at 7 years old and previous urinary tract infection. Arch Dis Child. 1991;66:232–4.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Ammenti A, Cataldi L, Chimenz R, et al; Italian Society of Pediatric Nephrology. Febrile urinary tract infections in young children: recommendations for the diagnosis, treatment and follow-up. Acta Paediatr. 2012;101:451–7.Google Scholar
  5. 5.
    Collins CH, Lyne PM. Microbiological methods. 5th ed. London: Butterworths; 1985. p. 128–34.Google Scholar
  6. 6.
    Bradley M, Schumann GB. Examination of urine. In: Henry JB, editor. Clinical diagnosis and management by laboratory methods. 17th ed. Philadelphia: WB Saunders; 1984. p. 380–458.Google Scholar
  7. 7.
    Manoni F, Fornasiero L, Ercolin M, et al. Quantificazione della batteriuria e dei leucociti urinari mediante Sysmex UF-1000i: confronto con la coltura quantitativa. Ital J Lab Med. 2009;5:44–9.Google Scholar
  8. 8.
    Manoni F, Ercolin M, Bountis I, et al. Valutazione dell’analizzatore Sysmex UF-1000i per l’esame automatizzato del sedimento urinario. Biochim Clin. 2009;33:550–5.Google Scholar
  9. 9.
    De Rosa R, Grosso S, Bruschetta G, et al. Evaluation of the Sysmex UF1000i flow cytometer for ruling out bacterial urinary tract infection. Clin Chim Acta. 2010;411:1137–42.CrossRefPubMedGoogle Scholar
  10. 10.
    Hodson EM, Craig JC. Urinary tract infection in children. In: Avner ED, Harmon WE, Niaudet P, Yoshikawa F, Emma F, Goldstein SL, editors. Pediatric nephrology. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2016. p. 1696–714.Google Scholar
  11. 11.
    Evidence-based care guideline for medical management of first urinary tract infection in children 12 years of age or less. Cincinnati: UTI Guideline Team. Cincinnati Children’s Hospital Medical Center; 2006. p. 1–23.Google Scholar
  12. 12.
    Pieretti B, Brunati P, Pini B, et al. Diagnosis of bacteriuria and leukocyturia by automated flow cytometry compared with urine culture. J Clin Microbiol. 2010;48:3990–6.Google Scholar
  13. 13.
    Kanegaye JT, Jacob JM, Malicki D. Automated urinalysis and urine dipstick in the emergency evaluation of young febrile children. Pediatrics. 2014;134:523–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Hooton TM, Roberts PL, Cox ME, Stapleton AE. Voided midstream urine culture and acute cystitis in premenopausal women. N Engl J Med. 2013;369:1883–91.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Doern CD, Richardson SE. Diagnosis of urinary tract infections in children. J Clin Microbiol. 2016;54:2233–42.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Kim SY, Kim YJ, Lee SM, et al. Evaluation of the Sysmex UF-100 urine cell analyzer as a screening test to reduce the need for urine cultures for community-acquired urinary tract infection. Am J Clin Pathol. 2007;128:922–5.Google Scholar
  17. 17.
    Stein R, Dogan HS, Hoebeke P, et al; European Association of Urology and European Society for Pediatric Urology. Urinary tract infections in children: EAU/ESPU guidelines. Eur Urol. 2015;67:546–58.Google Scholar
  18. 18.
    Manoni F, Fornasiero L, Ercolin M, et al. Cut-off values for bacteria and leukocytes for urine flow cytometer Sysmex UF-1000i in urinary tract infections. Diagn Microbiol Infect Dis. 2009;65:103–7.Google Scholar
  19. 19.
    Broeren MA, Bahçeci S, Vader HL, Arents NL. Screening for urinary tract infection with the Sysmex UF-1000i urine flow cytometer. J Clin Microbiol. 2011;49:1025–9.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2018

Authors and Affiliations

  1. 1.Department of Pediatric NephrologyEge University Faculty of MedicineİzmirTurkey

Personalised recommendations