Comparison of Urine Culture and Flow Cytometric Methods for Detecting Bacteriuria by Using a Simulation Model

Elif Isbilen; Yasemin Zer; Deniz Gazel; Kaan Çeylan

doi:10.5152/eurjther.2021.21051

Authors

Elif Isbilen Department of Medical Biochemistry, Gaziantep University Faculty of Medicine, Gaziantep, Turkey https://orcid.org/0000-0003-3469-3645
Yasemin Zer Department of Medical Microbiology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey https://orcid.org/0000-0002-9078-9900
Deniz Gazel Department of Medical Microbiology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey https://orcid.org/0000-0003-2764-3113
Kaan Çeylan Department of Medical Microbiology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey https://orcid.org/0000-0002-8493-2715

DOI:

https://doi.org/10.5152/eurjther.2021.21051

Keywords:

Urinary tract infections, urine culture, flow cytometric method, simulation model

Abstract

Objective: We aimed to simulate and assess a new screening model to determine and exclude culture negative urine samples before culturing for patients with preliminary diagnosis of urinary tract infections (UTIs). This prospective and single-center research included a simulation model that studied in a central laboratory between March and April 2020. All samples studied fluorescent flow cytometry (FC) analyzer and then inoculated to medium. Methods: Simulations of infected urine were created by mixing certain amounts microorganisms with the urine. Standard Escherichia coli, Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans strains, one Lactobacillus spp., and one Staphylococcus epidermidis clinical isolate were used in the study. After the dilution process, 42 infected urine samples were analyzed using UF5000i FC device and urine culture method. Correlation between the methods (culture and FC) for bacterial counts was assessed with the in-class correlation coefficient and Spearman correlation coefficient. Results: A significant agreement was observed between the methods only for the urine dilution containing 105 CFU mL1 pathogen. Conclusion: The flow cytometric system failed to predict bacteriuria and the risk of urinary tract infection in our simulation model. Further research in combination with other parameters is needed to see the real power of flow cytometric methods for screening UTIs.

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References

Koneman EW, Allen SD, Janda WM, et al. Urinary Tract Infections: Color Atlas and Textbook of Diagnostic Microbiology. 5th ed. Philadelphia, New York: Lippincott Comp, 1996: 136.

Tıbbi Mikrobiyoloji Uzmanları Ic¸in Klinik O¨ rnekten Sonuc¸ Raporuna Uygulama Rehberi, U¨ riner Sistem O¨ rnekleri. Ankara: KL_IMUD

Yayınları C ag˘han Ofset Matbaacılık, 2015.

O¨ zc¸akar ZB, Yalc¸ınkaya F. _Idrar yolu enfeksiyonları. Tu¨rkiye Klinikleri Pediatri Dergisi. 2007;3:99-104.

Monsen T, Ryden P. Flowcytometry analysis using Sysmex UF-1000i classifies uropathogens based on bacterial, leukocyte, and erythrocyte counts in urine specimens among patients with urinary tract infections. J Clin Microbiol. 2015;53(2):539-545.

Okada H, Sakai Y, Kawabata G, et al. Automated urine analysisevaluation of the Sysmex UF-50. Am J Clin Pathol. 2001;115(4):605-

Jolkkonen S, Paattiniemi EL, Karpanoja P, et al. Screening of urine samples by flow cytometry reduces the need for culture. J Clin

Microbiol. 2010;48(9):3117-3121.

Wang J, Zhang Y, Xu D, et al. Evaluation of the Sysmex UF-1000i for the diagnosis of urinary tract infection. Am J Clin Pathol.

;133(4):577-582.

De Rosa R, Grosso S, Lorenzi G, et al. Evaluation of the new Sysmex UF-5000 fluorescence flow cytometry analyser for ruling out bacterial urinary tract infection and for prediction of gram negative bacteria in urine cultures. Clin Chim Acta. 2018;484:171-178.

Previtali G, Ravasio R, Seghezzi M, et al. Performance evaluation of the new fully automated urine particle analyser UF-5000 compared to the reference method of the Fuchs-Rosenthalchamber. Clin Chim Acta. 2017;472:123-130.

Bilgehan H. Klinik Mikrobiyolojik Tanı, 3. Baskı, _Izmir: Barıs Yayınları Faku¨ lteler Kitabevi, 2002.

Davenport M, Mach KE, Shortliffe LMD, et al. New and developing diagnostic technologies for urinary tract infections. Nat Rev Urol.

;14(5):296-310.

Ay C, Cantu¨ rk Z. Flowsitometrinin mikrobiyoloji alanında kullanımı. Erciyes U¨niversitesi Fen Bilimleri Enstitu¨su¨ Fen Bilimleri Dergisi.

;31(3):144-151.

U¨ zmez E, Yag˘cı S, Yu¨ cel M, et al. _Idrarda Lo¨kosit/Bakteri Analizi Yapan Akım Sitometri Cihazı Sonuc¸ları ile _Idrar Ku¨ltu¨ru¨ Sonuc¸larının Kars ılas tırılması Tu¨rk Mikrobiyol Cem Derg. 2018;48(1):78-85.

Ren C, Wu J, Jin M, et al. Rapidly discriminating culturenegative urine specimens from patients with suspected urinary

tract infections by UF-5000. Bioanalysis. 2018;10(22):1833-1840.

Ippoliti R, Allievi I, Rocchetti A. UF-5000 flow cytometer: A new technology to support microbiologists’ interpretation of suspected

urinary tract infections. Microbiol Open. 2020;9:E987.

Kim SY, Park Y, Kim H, et al. Rapid screening of urinary tract infection and discrimination of gram-positive and gram-negative bacteria by automated flow cytometric analysis using Sysmex UF-5000. J Clin Microbiol. 2018;56(8):e02004-e02017.