Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(23), P. 7453 - 7453
Published: Dec. 7, 2024
We aimed to compare the prescribing behavior and clinical experience of urology providers when using combined multiplex polymerase chain reaction (M-PCR)/Pooled Antibiotic Susceptibility Testing (P-AST) diagnostic test versus standard urine culture (SUC) in same set patients previously reported have improved outcomes with M-PCR/P-AST.
Language: Английский
BMC Infectious Diseases, Journal Year: 2024, Volume and Issue: 24(1)
Published: Jan. 31, 2024
Abstract Background Current diagnoses of urinary tract infection (UTI) by standard urine culture (SUC) has significant limitations in sensitivity, especially for fastidious organisms, and the ability to identify organisms polymicrobial infections. The rate both SUC “negative” or “mixed flora/contamination” results UTI cases high prevalence asymptomatic bacteriuria indicate need an accurate diagnostic test help true cases. This study aimed determine if infection-associated biomarkers can differentiate definitive from non-UTI controls. Methods Midstream clean-catch voided samples were collected volunteers symptomatic subjects ≥ 60 years old diagnosed with a urology specialty setting. Microbial identification density assessed using multiplex PCR/pooled antibiotic susceptibility (M-PCR/P-AST) SUC. Three [neutrophil gelatinase-associated lipocalin (NGAL), Interleukins 8 1β (IL-8, IL-1β)] also measured via enzyme-linked immunosorbent assay (ELISA). Definitive defined as diagnosis positive microorganism detection M-PCR, while volunteers. Results We observed strong correlation (R 2 > 0.90; p < 0.0001) between microbial NGAL, IL-8, IL-1β subjects. Biomarker consensus criteria two more had sensitivity 84.0%, specificity 91.2%, predictive value 93.7%, negative 78.8%, accuracy 86.9%, likelihood ratio 9.58, 0.17 differentiating cases, regardless non-zero density. showed elevation microbe compared without identification. exhibited distinguishing Conclusion demonstrated that IL-1β, and/or M-PCR was associated A criterion meeting positivity thresholds good balance (84.0%), (91.2%), (86.9%). Therefore, this biomarker is excellent supportive tool resolving presence active UTI, particularly disagree.
Language: Английский
Citations
14
Antibiotics, Journal Year: 2025, Volume and Issue: 14(2), P. 143 - 143
Published: Feb. 1, 2025
Background/Objectives: Urinary tract infections (UTIs) pose an increasing risk of antimicrobial resistance, and novel diagnostic tests have been developed to address the limitations standard urine culture in these cases. It is important that be validated for agreement error rates against antibiotic susceptibility testing (AST) methods. Methods: Polymicrobial (≥two non-fastidious microorganisms) consecutive clinical specimens submitted UTI were included this analysis. Specimens tested with Pooled Antibiotic Susceptibility Testing (P-AST) broth microdilution/disk diffusion (BMD/DD) parallel. Performance characteristics, such as essential (EA%), very major errors (VMEs), (MEs), assessed using Clinical Laboratory Standards Institute (CLSI) standards. P-AST-resistant BMD/DD consensus-sensitive results heteroresistance. Real-world sample data used assess associations between organism counts average “sensitive” count per sample. Results: The P-AST isolate AST was ≥90%, VMEs <2.0%, MEs <3.0%, meeting CLSI guidelines verification validation studies. When heteroresistance accounted for, overall both <1.5%. presence additional organisms dropped number antibiotics from 9.8 one 2.5 five or more organisms. fastidious did not any meaningful impact. Conclusions: P-AST, a component Guidance® assay (Pathnostics, Irvine, CA, USA), performed within standards polymicrobial specimens.
Language: Английский
Citations
1
Microorganisms, Journal Year: 2025, Volume and Issue: 13(4), P. 949 - 949
Published: April 20, 2025
Clinical success in treating complicated urinary tract infections (cUTIs) depends on accurate pathogen detection, given the common occurrence of polymicrobial and antimicrobial resistance. This multicenter, randomized, investigator-blinded study compared polymerase chain reaction (PCR)-based diagnostics to conventional culture sensitivity (C&S) testing guiding treatment cUTIs. PCR identified 43.52% cases, a significantly higher rate than that observed with C&S (31.95%, p = 0.033). Patients arms undetected had clinical failure (33.33%, 14/42, 0.041) those concordant infection identification by both methods (22.22%, 12/54). also detected additional pathogens 54.44% (92/169) cases arm, where was when missed (28.26% vs. 14.29%, 0.015). Similarly, failed detect phenotypic resistance (compared PCR), occurred 50% (16/42) 13.22% (21/121, 0.001) detection (PCR C&S). To further illustrate impact, patient-level case analyses are included demonstrate how PCR-guided therapy improved enabled more appropriate selection C&S. These findings highlight limitations detecting infections, resistance, hetero-resistance due its limited clonal analysis, supporting integration for optimized cUTI management.
Language: Английский
Citations
1
Investigative and Clinical Urology, Journal Year: 2025, Volume and Issue: 66(3), P. 261 - 261
Published: Jan. 1, 2025
We aimed to evaluate the effect of long-term oral OM-89 therapy on urinary microflora in patients with urolithiasis. Patients underwent surgical removal stones followed by no treatment for six months or daily administration. Urine culture and polymerase chain reaction (PCR) were performed at baseline visit (V1) 2 (V2) 6 (V3) after operation. A total 113 completed study. The rate bacteria detection urine V3 did not differ between treated untreated groups (p>0.999); however, PCR tended be higher group than (p=0.052). Escherichia coli Enterococcus spp. most commonly detected via both all timepoints. Risk factors positive V1 (p=0.048) female sex (p=0.048), whereas was associated (p=0.023), V2 (p<0.001), (p=0.038). use decreased rates bacterial a further decrease V3. Long-term immunization could frequency colonization stones. used as complementary if retrieved stone is suspected related infection.
Language: Английский
Citations
0
Frontiers in Pediatrics, Journal Year: 2024, Volume and Issue: 12
Published: May 22, 2024
Introduction Early and accurate diagnosis of urinary tract infection (UTI) can prevent serious sequelae including chronic kidney disease. Multiple individual studies have identified urine neutrophil gelatinase-associated lipocalin (uNGAL) as a promising biomarker for early UTI. We sought to understand the distribution diagnostic accuracy uNGAL values in patients presenting with UTI symptoms. Methods Our systematic literature reviews PubMed, Embase, Cochrane Reviews up March 2024, 25 reporting mean/median, standard deviation/quartiles, detection limits symptomatic without culture-confirmed Seventeen were children. Meta-analyses performed using quantile estimation (QE) method estimating distributions uNGAL, which then compared between non-UTI groups identifying best cut-off points maximizing Youden index. Sensitivity analyses on all adult patients. Results found that levels significantly higher samples confirmed those without. In pediatric studies, median 95% confidence interval (CI) 22.41 (95% CI 9.94, 50.54) ng/mL group vs. 118.85 43.07, 327.97) group. estimated point 48.43 highest sensitivity (96%) specificity (97%) analysis both yielded similar results. Discussion The level is much than reported It may be used tool identify among range concentrations subjects lower acute intrinsic injury. Systematic Review Registration https://www.crd.york.ac.uk/ , PROSPERO (CRD42023370451).
Language: Английский
Citations
3
International Journal of Women s Health, Journal Year: 2024, Volume and Issue: Volume 16, P. 1595 - 1605
Published: Sept. 1, 2024
This article aims to bring clinicians' awareness the widespread impact of urinary tract infection (UTI) on lives women and advances that offer hope for future improvements in diagnosis management UTI. Thanks physiological, anatomical, lifestyle factor differences, face heightened vulnerability UTIs compared men. In fact, are four times more likely than men develop a UTI around half these encounter recurrence, which is significant source both physical psychosocial burdens. Despite current shortcomings management, emerging diagnostic technologies promise identify accurately rapidly, offering revolution management. Meanwhile, clinicians have opportunity reduce burden by recognizing value patients' lived experiences ensuring their care plan alignment with goals expectations medical care.
Language: Английский
Citations
2
Clinical Microbiology Reviews, Journal Year: 2024, Volume and Issue: unknown
Published: Dec. 6, 2024
SUMMARY Urinary tract infection (UTI) is among the most common infections in clinical practice. In some cases, if left untreated, it can lead to pyelonephritis and urosepsis. other UTI resolves without treatment. Clinical diagnosis typically based on patient symptoms and/or urinalysis, including urine dipsticks. The standard culture method sometimes employed identify suspected urinary pathogen (uropathogen) guide antimicrobial choice, but results are rarely available before 24 h. also misses fastidious, anaerobic, slow-growing uropathogens reports polymicrobial infections. unexplained combination of negative cultures with persistent distressing both patients clinicians. Given broad appreciation advantages provided by rapid testing (e.g., for COVID-19 or influenza A), a rapid, accurate diagnostic test needed deliver timely treatment seeking care that optimizes antibiotic stewardship. Herein, we discuss progress being made toward an accessible, (i.e., within hours), assay clinically useful treating clinician timeframe growth rate pathogen(s)). New emerging often overlooked current techniques reviewed.
Language: Английский
Citations
2
Antibiotics, Journal Year: 2024, Volume and Issue: 13(12), P. 1214 - 1214
Published: Dec. 14, 2024
Background/Objectives: While new methods for measuring antimicrobial susceptibility have been associated with improved patient outcomes, they should also be validated using standard protocols error rates and other test metrics. The objective of this study was to validate a novel assay complicated recurrent urinary tract infections (UTIs): pooled antibiotic testing (P-AST). This compared broth microdilution (BMD) disk diffusion (DD), following Clinical Laboratory Standards Institute (CLSI) guidelines assessment agreement. Methods: analyzed consecutive fresh clinical urine specimens submitted UTI diagnostic testing. Upon receipt, the samples were subjected in parallel culture multiplex polymerase chain reaction (M-PCR) microbial identification quantification. Specimens same monomicrobial non-fastidious bacteria detected by both M-PCR (SUC) underwent (AST) P-AST Analysis undertaken assess presence heteroresistance P-AST-resistant BMD/DD consensus-susceptible results. Results: performance measures without correction showed essential agreement (EA%) ≥90%, very major errors (VMEs) <1.5%, (MEs) <3.0% P-AST, all meeting threshold established CLSI AST. categorical (CA%) met acceptable criteria (>88%), as majority minor (mEs) decreased <1.0% when accounted for. Conclusions: methodology is within parameters criteria.
Language: Английский
Citations
2
Biomedicines, Journal Year: 2024, Volume and Issue: 12(11), P. 2582 - 2582
Published: Nov. 12, 2024
Urinary tract infections (UTIs) are common bacterial in children. UTIs may be limited to the bladder or involve kidneys with possible irreversible damage. Congenital abnormalities of kidney and urinary (CAKUT) often associated UTIs; scars have been considered a consequence untreated but congenital. The mechanism by which bacteria produce inflammation system has intensively investigated. Diagnostic tools, including invasive imaging procedures, advocated infants small children not necessary most cases. Effective antibiotic drugs available, prophylactic treatment questioned. Several guidelines on simple one for general practitioners is needed.
Language: Английский
Citations
1
Diagnostic Microbiology and Infectious Disease, Journal Year: 2024, Volume and Issue: 111(3), P. 116646 - 116646
Published: Dec. 7, 2024
Complicated urinary tract infections (cUTIs) are difficult to manage due their polymicrobial nature and resistance standard therapies. In current clinical practice, the management of a cUTI often starts with broad-spectrum antimicrobials until culture sensitivity (C&S) results available, but these diagnostic delays further hinder treatment efficacy. Polymerase Chain Reaction (PCR) offers faster alternative. This study evaluates PCR's utility compared C&S, focusing on agreeability, discordant results, outcomes, antimicrobial selection efficacy improve management.
Language: Английский
Citations
1