NEW ORLEANS — A new test performed on women discovered significantly more bacteria species than the standard test for urinary tract infection, according to findings presented at ASM Microbe.
According to the American Urological Association, UTIs account for as many as 8.1 million visits to health care providers every year, and are the second-most common infection treated in the ED. The data also show that a woman’s lifetime risk for contracting at least one UTI ranges from approximately 40% to more than 50%.
Travis Price, MS, of Loyola University, and colleagues prospectively enrolled 150 urogynecologic patients and divided the group based on their answer to the question: ‘Do you feel you have a UTI?'
Researchers then conducted a standard urine culture of catheterized urine specimens. They also assessed bacterial growth using three versions of an enhanced quantitative urine culture protocol that utilized multiple media, an expansion of environmental culturing conditions, and 3 volumes of urine plated (1 µL, 10 µL and 100 µL). Price and colleagues also determined microbiota diversity using the average number of unique species per urine specimen.
Researchers found that the 100 µL enhanced quantitative urine culture protocol detected significantly more unique species (n = 95) than the standard urine culture (n = 11). Of all the uropathogens detected by the enhanced quantitative urine culture protocols, the standard urine culture missed 67% (122/182). In addition, in the ‘Yes’ cohort alone, standard urine culture missed 50% of the uropathogens. Standard culture detected 88% of the Escherichia coli (44/50), and discovered only 12% (16/132) of all other uropathogens. and streamlined enhanced quantitative urine culture detected more uropathogens (84%) than standard urine culture (33%).
“These findings support the necessity for an immediate change in urine culture procedures,” Price and colleagues wrote. “We recommend use of a streamline version of enhanced quantitative urine culture 100µL urine on Blood, CNA, and MacConkey agar incubated in 5% CO2 with 48 hours of incubation.”
According to a press release, another clinical trial will be conducted to investigate whether using the enhanced quantitative urine culture method could improve the clinical care of women with UTIs. The release also stated that 75 women with UTI symptoms will receive the standard culture plus enhanced quantitative urine culture and 150 women will receive the standard culture alone. – by Janel Miller
NIH Webpage on UTIs in Women (accessed 06-02-17)
Price, T. et al. Detecting clinically relevant microorganisms: We can do better. Presented at: ASM Microbe; June 1-5, 2017; New Orleans.
Disclosure: Healio Family Medicine was unable to determine researchers’ relevant financial disclosures prior to publication.