With around 150 million affected individuals globally, urinary tract infections (UTI) are among the most frequent bacterial infections. UTIs are accountable for millions of medical consultations and put significant burden on healthcare systems and societies [1,2].

Despite its costly and time-consuming nature, urine culture remains the gold standard in UTI diagnostics and accounts for up to 40% of the overall requested cultures in a lab [3]. This workflow can clog up resources in the laboratory as well as cause a gap in communication between the lab and clinicians, which can trickle down to patients and treatment methods. 80% of suspected UTI samples turn out to be negative, therefore a fast and reliable method to exclude UTI can be a driver for laboratory workflow improvements and antimicrobial stewardship [4].

Rule out UTI in less than a minute

With a diagnostic performance of 0.973 (AUC), the UF-series can provide quantitative information on bacteriuria in less than a minute. A recent investigation of different cut-off values revealed a bacteria count of ≥ 58 cells/μL as the most sensitive value for ruling out urinary tract infections with a sensitivity of 99.4 % (NPV 99.7 %) and a specificity of 78.2 % (PPV 65.4 %) [5].

The UF-series utilises fluorescence flow cytometry, which is a technology that can also benefit the antibiotic susceptibility testing (AST) process by screening samples. that negative UTI samples can be ruled out with this technology, culture plating and general workload can be optimised. There is also the possibility to utilise bacteria information flags which can predict positive samples containing Gram negative bacteria for Direct Antibiotic Susceptibility Testing (dAST). dAST on the positive urine samples can reduce response time for antibiotic profile by up to 24 hours, and thus contribute to reduced empiric use of antibiotic and shorter overall treatment. [6]

[.CH-fr Switzerland (french)] UF-series utilises fluorescence flow cytometry

Beyond urinalysis

Antibiotic susceptibility testing to address UTI workflow

In addition, antibiotic susceptibility testing (AST) is an important laboratory test to initiate a targeted antibiotic treatment and fight antimicrobial resistance (AMR). There are newer technologies under development to improve and speed up the AST process. One technology measures the growth rate of bacterial cells in real time through microfluidics and image analysis methods. A sample is loaded onto a microfluidic chip and any bacteria present are caught in bacteria-sized traps. The trapped bacteria are monitored, whereby the loading time gives an estimate of the density of bacteria in the sample. Bacterial growth is monitored in each trap, some of which contain a candidate antibiotic. The average growth rates are calculated in real time and the bacteria are considered susceptible if its growth is duly inhibited.

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