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Dumitru, Georgiana, Diana-Gabriela Soare, and Teodoru Soare. "Urine – cytological aspect and microbiology notions." Practica Veterinara.ro 4, no. 33 (2018): 49. http://dx.doi.org/10.26416/pv.33.4.2018.2110.
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Gur’ev, A. S., O. Yu Shalatova, E. V. Rusanova, I. V. Vasilenko, and A. Yu Volkov. "Coherent fluctuation nephelometry in clinical microbiology." Russian Journal of Infection and Immunity 9, no. 2 (July 12, 2019): 385–92. http://dx.doi.org/10.15789/2220-7619-2019-2-385-392.
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In this article data concerning coherent fluctuation nephelometry (CFN) use in clinical microbiology is presented. CFN-analyzer allows to solve two important problems – fast urine screening for bacteriuria within 2-4 hours and antibiotic susceptibility testing within 3-6 hours. Altogether more than 650 urine samples were tested, and the effectivity of CFN-analyzer for preliminary selection of samples for further analysis was shown. Method allows to detect negative samples, reducing the number of urine analyses by 70-80%. Simultaneous analysis of growth curves and concentration of microorganisms shows high sensitivity and specificity (95.2% и 96.9%). Also more than 250 antibiotic susceptibility tests were performed using CFN-analyzer to show its effectiveness for determination of resistant properties of both pure cultures and urine microflora without isolation of bacteria. The agreement with traditional methods was from 84% to 88%. The use of CFN-analyzer with express methods of identification of microorganisms (chromogenic nutrient broths or mass-spectrometry) allows to make full urine analysis within 1-2 days. In the future CFN-analyzer gives an opportunity to screen different human biological liquids, and finds an application for other microbiological tasks, including standardization and speeding-up in sanitary bacteriology.
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Tallman, Gregory B., Miriam R. Elman, Adriane N. Irwin, Brie N. Noble, Peter K. Atkins, YoungYoon Ham, Kallie Waldrip, and Jessina C. McGregor. "Impact of Culturing All Uncomplicated Urinary Tract Infections on the Estimated Prevalence Of Resistance in the Primary Care Setting." Open Forum Infectious Diseases 4, suppl_1 (2017): S349. http://dx.doi.org/10.1093/ofid/ofx163.839.
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Abstract Background Urine cultures to confirm a urinary tract infection (UTI) are not consistently collected in the primary care setting; thus estimates of the prevalence of resistance in uropathogens may be biased. As part of an ongoing study, microbiologic cultures were collected for all patients presenting with uncomplicated UTI at primary care clinics over a six-month period to assess the potential misclassification in frequency of resistance. Methods Data from an electronic health record repository were used to identify clinic encounters for women with a diagnosis code for unspecified UTI or cystitis from six primary care clinics between October 1, 2015 and February 28, 2017 in this cross-sectional study. Prior to August 22, 2016, urine microbiology cultures were collected at the discretion of the provider (usual care period), and from August 22, 2016 to February 28, 2017 urinary microbiology cultures were collected from all patients suspected of having uncomplicated UTI (full culturing period). Urinary microbiology culture and pharmacy data occurring within three days of the encounter were collected. Antibiotic susceptibility data was summarized for isolated Enterobacteriaceae. Frequency of susceptibility to trimethoprim-sulfamethoxazole (TMP-SMX), nitrofurantoin, and fluoroquinolones were compared between usual care vs. the full culturing periods using a chi-square test. Results We identified 131 urine microbiology cultures in the usual care period and 104 in the full culturing period with 61.1% and 55.8%, respectively, being positive cultures. Enterobacteriaceae were isolated from 85.0% of positive cultures in the usual care period and 86.2% in the full culturing period. Between the usual and full culturing periods, antibiotic susceptibility in the Enterobacteriaceae did not differ statistically for TMP-SMX (85.1% vs.. 88.0%; P = 0.65), nitrofurantoin (98.5% vs. 94.0%; P = 0.19), and fluoroquinolones (89.6% vs. 90.0%; P = 0.94). Conclusion Full culturing did not significantly change estimates of the prevalence of antibiotic resistance among Enterobacteriaceae isolated from urine samples. Current urine culturing practices provide adequate susceptibility information to inform empiric prescribing for women with uncomplicated UTIs. Disclosures J. C. McGregor, Merck & Co.: Grant Investigator, Research grant
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Noble, Michael A., and Shirley Nikiforuk. "Variability in Urine Culture Reporting by Canadian Microbiology Laboratories." Canadian Journal of Infectious Diseases 7, no. 4 (1996): 247–49. http://dx.doi.org/10.1155/1996/238498.
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OBJECTIVE: To determine the ability of microbiology laboratories to perform and to report urine colony counts.DESIGN: Clinical Microbiology Proficiency Testing program participants received stabilized simulated urine samples. Laboratories were asked to perform the appropriate test and report results.PARTICIPANTS: One hundred and nine clinical microbiology laboratories in British Columbia, Alberta and Nova Scotia.OUTCOME MEASURES: Consistency of reporting was compared with standards for reporting results as described in theSI Manual in Health Care, 2nd edition.RESULTS: The study demonstrated a wide variation in units used for the reporting of results. Ninety-five (87.2%) laboratories reported quantitative urine results in a variety of unit styles. Of those laboratories providing results with units, 80 (84.2%) used one of 10 variations of SI reporting styles. Fifteen (16.8%) laboratories reported metric units in three different styles. Eleven (10.0%) laboratories reported semiquantitative values without stating units. The remaining three (2.8%) did not respond to the survey.CONCLUSIONS: Many clinical microbiology laboratories have not adopted a consistent form of SI units for reporting quantitative urine culture results. This lack of consistency could potentially lead to interpretation confusion.
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Quiblier, Chantal, Marion Jetter, Mark Rominski, Forouhar Mouttet, Erik C. Böttger, Peter M. Keller, and Michael Hombach. "Performance of Copan WASP for Routine Urine Microbiology." Journal of Clinical Microbiology 54, no. 3 (December 16, 2015): 585–92. http://dx.doi.org/10.1128/jcm.02577-15.
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This study compared a manual workup of urine clinical samples with fully automated WASPLab processing. As a first step, two different inocula (1 and 10 μl) and different streaking patterns were compared using WASP and InoqulA BT instrumentation. Significantly more single colonies were produced with the10-μl inoculum than with the 1-μl inoculum, and automated streaking yielded significantly more single colonies than manual streaking on whole plates (P< 0.001). In a second step, 379 clinical urine samples were evaluated using WASP and the manual workup. Average numbers of detected morphologies, recovered species, and CFUs per milliliter of all 379 urine samples showed excellent agreement between WASPLab and the manual workup. The percentage of urine samples clinically categorized as positive or negative did not differ between the automated and manual workflow, but within the positive samples, automated processing by WASPLab resulted in the detection of more potential pathogens. In summary, the present study demonstrates that (i) the streaking pattern, i.e., primarily the number of zigzags/length of streaking lines, is critical for optimizing the number of single colonies yielded from primary cultures of urine samples; (ii) automated streaking by the WASP instrument is superior to manual streaking regarding the number of single colonies yielded (for 32.2% of the samples); and (iii) automated streaking leads to higher numbers of detected morphologies (for 47.5% of the samples), species (for 17.4% of the samples), and pathogens (for 3.4% of the samples). The results of this study point to an improved quality of microbiological analyses and laboratory reports when using automated sample processing by WASP and WASPLab.
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Ordóñez-Mena, JM, Thomas R. Fanshawe, Dona Foster, Monique Andersson, Sarah Oakley, Nicole Stoesser, A. Sarah Walker, and Gail Hayward. "Frequencies and patterns of microbiology test requests from primary care in Oxfordshire, UK, 2008–2018: a retrospective cohort study of electronic health records to inform point-of-care testing." BMJ Open 11, no. 11 (November 2021): e048527. http://dx.doi.org/10.1136/bmjopen-2020-048527.
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ObjectivesTo inform point-of-care test (POCT) development, we quantified the primary care demand for laboratory microbiology tests by describing their frequencies overall, frequencies of positives, most common organisms identified, temporal trends in testing and patterns of cotesting on the same and subsequent dates.DesignRetrospective cohort study.SettingPrimary care practices in Oxfordshire.Participants393 905 patients (65% female; 49% aged 18–49).Primary and secondary outcome measuresThe frequencies of all microbiology tests requested between 2008 and 2018 were quantified. Patterns of cotesting were investigated with heat maps. All analyses were done overall, by sex and age categories.Results1 596 752 microbiology tests were requested. Urine culture±microscopy was the most common of all tests (n=673 612, 42%), was mainly requested without other tests and was the most common test requested in follow-up within 7 and 14 days. Of all urine cultures, 180 047 (27%) were positive and 172 651 (26%) showed mixed growth, and Escherichia coli was the most prevalent organism (132 277, 73% of positive urine cultures). Antenatal urine cultures and blood tests in pregnancy (hepatitis B, HIV and syphilis) formed a common test combination, consistent with their use in antenatal screening.ConclusionsThe greatest burden of microbiology testing in primary care is attributable to urine culture ± microscopy; genital and routine antenatal urine and blood testing are also significant contributors. Further research should focus on the feasibility and impact of POCTs for these specimen types.
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Khatun, Khadeza, AHM Mostafa Kamal, Kazi Afzalur Rahman, Mohammad Zaid Hossain, Nadia Rabin, SM Shamsuzzaman, and Syed Zakir Hossain. "A Comparative Study of Routine Microscopic Examination of Urine in Microbiology Laboratories at Primary and Secondary Level Before and After Implementation of Standard Operating Procedure (SOP)." Journal of Dhaka Medical College 25, no. 2 (September 13, 2017): 87–93. http://dx.doi.org/10.3329/jdmc.v25i2.33972.
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Context : Laboratory services have become an integral and inseparable component of modern medicine and public health. The use of standard operating procedure (SOP) in laboratory testing is one of the most crucial factor in achieving the quality. This cross sectional study was done to assess the quality of routine microscopic examination of urine of a microbiology laboratory at primary level and one microbiology laboratory at secondary level by evaluating the test results before SOP and re evaluating the test results after implementing SOP to see if there was any improvement in quality of those tests.Material and Methods: A cross sectional, descriptive type of study was conducted in Narsingdi Sador Hospital as secondary level microbiology laboratory and Polash Upzilla Health Complex as primary level microbiology laboratory. The study was performed on clinically suspected patients of urinary tract infection (UTI) attending at the primary and secondary level laboratory for microscopic examination of urine. Clinically suspected cases of UTI who had taken any anti microbial treatment in the past 48 hours were excluded from the study. 60 urine samples were collected from each level before implementing SOP and 30 urine samples were collected from each level and tested after following SOP.Result : In routine microscopic examination of urine at primary and secondary level, before SOP, regarding significant number of Pus cells discrepancy was found in 21.67% cases at primary level and 18.33% cases at secondary level. After implementing SOP, discrepancy in the result was reduced to 10% from 21.67% at primary level and 0% from 18.33% at secondary level. This difference in results was statistically significant (p< 0.05).Conclusion: Implementing SOP and after practicing appropriate and standard techniques for collection and examination of urine at primary and secondary level, discrepancy in the results of routine microscopic examination of urine between investigator and Medical Officer (MOPathology) was reduced and overall quality of tests were improved.J Dhaka Medical College, Vol. 25, No.2, October, 2016, Page 87-93
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Paluck, Felicia, Inbal Kestenbom, Gidon Test, Olivia Ostrow, and Brooke Brimmer. "97 Decreasing invasive urinary tract infection screening in a paediatric emergency department: A quality improvement initiative." Paediatrics & Child Health 26, Supplement_1 (October 1, 2021): e69-e71. http://dx.doi.org/10.1093/pch/pxab061.079.
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Abstract Primary Subject area Emergency Medicine - Paediatric Background Fever is a common presentation among children coming to the Emergency Department (ED) and a urinary tract infection (UTI) often needs to be excluded. Sterile techniques, like catheterization, are invasive, can be traumatizing to children, and are time consuming to complete. A two-step approach has been shown to reduce the catheterization rate in febrile, young children without unintended consequences. Objectives Our aim was to implement a two-step approach for UTI screening in febrile children 6-24 months in order to decrease unnecessary urine catheterizations by 50% without impacting ED length of stay (LOS) or return visits (RVs). Design/Methods After engaging key stakeholders and a nursing champion, we created a process map to understand the current urine collection process in our ED, and areas for targeted improvement. Using the model for improvement, we adopted a 2-step pathway for a suspected UTI in children 6-24 months as our change idea. The pathway involved identifying children who met inclusion criteria for UTI screening, followed by urine bag application and urinalysis (UA) if clinically indicated. Only if the UA was positive, a second urine sample was collected via catheterization, for repeat UA and culture. Through multiple PDSA cycles, our pathway was implemented in the ED along with concurrent staff education. The outcome measure was the rate of ED urine catheterizations. Process measures included the total number of urine cultures sent to microbiology and percent positivity. The balancing measures included ED LOS and RVs. Results Since project initiation in July 2019, the ED catheterization rate decreased from 73% to 53% (Figure 1) and the number of urine cultures sent to Microbiology decreased by 23%. The number of urine cultures sent to Microbiology decreased by 23% with a mild improvement in the positivity rate by 2% (Figure 2). There was no significant change in RVs. There was a slight 10-min increase in ED LOS, most likely confounded by the COVID pandemic. Conclusion Using improvement methodology, we successfully decreased the number of unnecessary catheterizations in children and the number of urine cultures sent to microbiology. Further refinements to our intervention are ongoing and include optimizing urine screening equipment in patient rooms, poster reminders, re-education for providers, and introducing a parent resource explaining the 2-step pathway. This improvement work is also being spread to the paediatric wards and can easily be adopted by other paediatric centres. It has also been adapted by the Choosing Wisely hospital campaign.
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Echavarria, Marcela, Michael Forman, John Ticehurst, J. Stephen Dumler, and Patricia Charache. "PCR Method for Detection of Adenovirus in Urine of Healthy and Human Immunodeficiency Virus-Infected Individuals." Journal of Clinical Microbiology 36, no. 11 (1998): 3323–26. http://dx.doi.org/10.1128/jcm.36.11.3323-3326.1998.
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Adenoviruses (AdV) cause diseases that range from localized, self-limited illnesses to fatal infections in immunocompromised patients. Culture is assumed to be sensitive but requires viable virus and up to 3 weeks for detection, and it can be inhibited by bacterial contamination. A new PCR method amplifying a region of the hexon gene was developed in order to detect AdV in urine more rapidly and with greater sensitivity than obtainable by culture technology. All 18 serotypes tested were detected. Quantitatively, with optimized urine processing, AdV PCR detected 0.2 PFU/ml (serotype 11) and 10 DNA copies/ml (serotype 2). Serially collected urine samples from human immunodeficiency virus (HIV)-infected patients with concurrent cytomegalovirus retinitis were divided into three groups: AdV culture-positive samples, AdV culture-negative or bacterially contaminated samples from patients with a history of AdV culture-positive urines, and AdV culture-negative samples from patients without a history of AdV culture positivity. Urine samples from healthy adults were also tested by culture and PCR to screen for asymptomatic shedding. Amplification was assessed with and without prior DNA purification. AdV was detected by PCR in 90% of culture-positive urines (100% of unclotted samples, e.g., those culture positive after storage for PCR testing), 71% of culture-negative or bacterially contaminated urines from AdV-infected patients, and 28% from AdV culture-negative patients. Healthy volunteers were culture negative for AdV, and 96% were PCR negative. The new AdV PCR method is rapid and sensitive and can detect viral DNA in samples for which culturing is problematic. The role of AdV replication during HIV infection merits further investigation with sensitive tools such as PCR.
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Adams, Jane, Thomas File, Matthew England, Nancy Reynolds, Patricia Wells, and Paula Politis. "Changing the Culture of Ordering Urine Cultures." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s162. http://dx.doi.org/10.1017/ice.2020.685.
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Background: Inappropriate ordering of urine cultures and the resulting unnecessary use of antibiotics can lead to complications of antimicrobial therapy including resistance, adverse effects (eg, disruption of microbiome and C. difficile infection), and increased healthcare costs, as well as the erroneous determination of CAUTI in patients with Foley catheters. A retrospective analysis of patients with CAUTI revealed frequent ordering of urine cultures for conditions and symptoms not supported by current IDSA guidelines. As a result, we created an action plan to reverse the trend of inappropriate urine culture ordering. Methods: Our urine culture reduction campaign was developed with input from the infectious disease service, antibiotic stewardship team (AST), infection prevention, pharmacy, and the microbiology service. The following educational efforts were included: (1) distribution of outpatient pocket cards with communication to providers about appropriate ordering of urine cultures; (2) creation of an evidence-based order set for urinalysis and urine cultures distributed electronically as emails and screensavers on computer stations and in person via didactic sessions with physicians and nursing staff; (3) a practice pointer for staff nurses that included recommended changes to urine culture ordering and encouraged open dialogue with physicians regarding the appropriateness of urine cultures; (4) didactic and personal communications to counter long-standing myths, such as “Urine cultures always for change in mental status”; (5) a peer-review process to evaluate and justify deviations from the testing algorithm.Results: The first and second months after the introduction of the campaign, the microbiology laboratory reported 23% and 37% reductions in urine cultures ordered, respectively. During the same period, a 48% reduction in CAUTIs was reported for the entire health system. Conclusions: Reducing the number of inappropriate urine cultures is achievable with intense communication utilizing a multifaceted approach. With continued educational activities, we expect to sustain and even improve our successful reduction of inappropriate urine culture orders, ultimately improving patient outcomes.Funding: NoneDisclosures: None
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Grude, N., A. Jenkins, Y. Tveten, and B. E. Kristiansen. "Identification of Aero coccus urinae in urine samples." Clinical Microbiology and Infection 9, no. 9 (September 2003): 976–79. http://dx.doi.org/10.1046/j.1469-0691.2003.00704.x.
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Domínguez, J. A., N. Galí, P. Pedroso, A. Fargas, E. Padilla, J. M. Manterola, and L. Matas. "Comparison of the Binax Legionella Urinary Antigen Enzyme Immunoassay (EIA) with the Biotest Legionella Urin Antigen EIA for Detection of Legionella Antigen in both Concentrated and Nonconcentrated Urine Samples." Journal of Clinical Microbiology 36, no. 9 (1998): 2718–22. http://dx.doi.org/10.1128/jcm.36.9.2718-2722.1998.
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We evaluated a newly commercial enzyme immunoassay (EIA) (BiotestLegionella Urin Antigen EIA; Biotest AG, Dreieich, Germany) for detection of antigens of all Legionella pneumophilaserogroups with a relatively wide spectrum of cross-reactivity as well as antigens of other Legionella spp. by comparing its sensitivity and specificity with those of an EIA for detection ofL. pneumophila serogroup 1 antigen (Legionella urinary antigen EIA; Binax, Portland, Maine). Both tests were performed with both concentrated and nonconcentrated urine samples. We also evaluated the capabilities of both EIAs to detect extracted soluble antigens of American Type Culture Collection (ATCC) Legionella strains (L. pneumophila serogroups 1 to 14, L. bozemanii, and L. longbeachae). The sensitivity of the Biotest EIA was 66.66% in nonconcentrated urine and 86.66% in concentrated urine. The sensitivity of the Binax EIA was 63.76% and 88.88% in nonconcentrated and concentrated urine, respectively. The specificity was 100% in nonconcentrated and concentrated urine for both assays. The Binax EIA and Biotest EIA detected extracted soluble antigens of L. pneumophila serogroups 1 to 14 and L. bozemanii ATCC strains. The cross-reactions observed with the Binax EIA were probably due to common epitopes directly related to lipopolysaccharide. Further studies are required to determine the usefulness of the Binax EIA for detection of urinary antigens fromLegionella species and serogroups other than L. pneumophila serogroup 1. The Biotest EIA proved to be as rapid, sensitive, and specific as the Binax EIA for the diagnosis of legionellosis. Concentration of antigen present in urine increased the sensitivities of both techniques with no reduction in specificity.
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Gajdács, M., M. Ábrók, A. Lázár, and K. Burián. "Microbiology of urine samples obtained through suprapubic bladder aspiration: A 10-year epidemiological snapshot." Developments in Health Sciences 2, no. 3 (September 2019): 76–78. http://dx.doi.org/10.1556/2066.2.2019.012.
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Purpose Suprapubic bladder aspiration is an invasive procedure in which a needle is used to obtain a urine sample directly from the bladder. Its advantages are sensitivity (detection of significant bacteriuria is close to 100%), suitability for cultivation of anaerobic bacteria, and low risk of contamination. Our purpose was to characterize the microbiology and epidemiology of urine samples obtained through this procedure in the Clinical Center of the University of Szeged’s Institute of Clinical Microbiology between 2008 and 2017. Materials and methods Over the 10-year period, patient data were collected and suprapubic bladder aspirations were performed, and the samples are processed in accordance with routine laboratory procedures in clinical bacteriology. Results Of 187 urine samples obtained from 148 patients, 32.6% (n = 61) were culture-positive (defined as 102 colony forming units/ml or more). Conclusions This method should be considered an important sampling procedure in the differential diagnostics of upper urinary tract infections, particularly in children <2 years of age, and in older people, hospitalized patients.
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Chung, Shiu-Dong, Chun-Hou Liao, and Hsu-Dong Sun. "Purple urine bag syndrome with acidic urine." International Journal of Infectious Diseases 12, no. 5 (September 2008): 526–27. http://dx.doi.org/10.1016/j.ijid.2008.02.012.
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Malowany, Moises S., John Kittick, and Margrit Good. "Cost Savings in Microbiology Urine Screening: An Alternative for Routine Culture." Laboratory Medicine 18, no. 5 (May 1, 1987): 304–5. http://dx.doi.org/10.1093/labmed/18.5.304.
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Church, Deirdre, and Daniel Gregson. "Screening urine samples for significant bacteriuria in the clinical microbiology laboratory." Clinical Microbiology Newsletter 26, no. 23 (December 2004): 179–83. http://dx.doi.org/10.1016/j.clinmicnews.2004.11.003.
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Sfeir, M. M., and T. M. Hooton. "Practices of clinical microbiology laboratories in reporting voided urine culture results." Clinical Microbiology and Infection 24, no. 6 (June 2018): 669–70. http://dx.doi.org/10.1016/j.cmi.2017.12.023.
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Stone, Judy, and Robert Manasse. "Pseudoepidemic of Urinary Tract Infections due to Trichosporon beigelii." Infection Control & Hospital Epidemiology 10, no. 7 (July 1989): 312–15. http://dx.doi.org/10.1086/646034.
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AbstractDuring the period April, 1985 to March, 1986, Trichosporon beigelii was isolated from the urine of 15 intensive care unit patients. All of these patients had Foley catheters in place at the time of T beigelii isolation. None of them had urinary tract infections on admission, and it was initially felt that this organism was a source of infection in these critically ill individuals. Subsequent investigation revealed this to be a pseudoepidemic secondary to contamination of the urinary catheter drainage system. Urine obtained by gravity drainage from the outlet port of urimeters yielded growth of T beigelii, whereas urines obtained concurrently from the proximal tubing sampling port were negative. T beigelii was isolated from the drainage port as well as from various items used in the collection and sampling of urine specimens. It is felt that these items were the source of perpetuation of this pseudoepidemic due to the repeated contamination and colonization of the distal portion of the urine catheter collection system. In-services to nursing and housekeeping personnel in the proper collection of urine specimens and cleaning of potentially contaminated items, the replacement of metal urine graduates with disposable plastic ones and increased monitoring of personnel's activities stopped the outbreak abruptly.
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Degarege, Abraham, Abebe Animut, Yohannes Negash, and Berhanu Erko. "Performance of Urine Reagent Strips in Detecting the Presence and Estimating the Prevalence and Intensity of Schistosoma haematobium Infection." Microorganisms 10, no. 10 (October 19, 2022): 2062. http://dx.doi.org/10.3390/microorganisms10102062.
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The performance of the urine reagent strips (URS) in detecting the presence and estimating the intensity of Schistosoma haematobium infection was evaluated using urine filtration microscopy as a reference standard. Urine samples collected from 1288 school-age children living in five villages of the Afar and one village in the Gambella Regional States of Ethiopia between October 2021 and April 2022 were examined using urine filtration and URS. The prevalence of S. haematobium infection was 31.6% based on urine filtration and 32.1% using URS. Using results of the urine filtration as a reference, the sensitivity, specificity, negative predictive values, and accuracy of the URS in detecting S. haematobium egg-positive urine specimens were 73.7%, 87.8%, 87.1%, and 82.8%, respectively. Sensitivity increased significantly with an increase in the urine egg count. Specificity was greater in low prevalence settings and among children aged 5–9 years. The level of hematuria detected was trace (19.1%), weak (30.2%), moderate (36.0%), or high (14.7%). The log odds of showing higher-level hematuria significantly increased as the number of egg counts in urine increased. In conclusion, URS remains good in rapidly screening individuals for S. haematobium infection, but the sensitivity of the test could be lower, particularly when the intensity of the infection is light.
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Vaidyanathan, Subramanian, and Bakul M. Soni. "Bluish Discolouration of Urine Drainage Tube and Bag in a Female Patient with Spina Bifida, Paraplegia, and Suprapubic Cystostomy." Scientific World JOURNAL 7 (2007): 1070–72. http://dx.doi.org/10.1100/tsw.2007.165.
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We present a female patient with spina bifida, paraplegia, suprapubic cystostomy, and chronic constipation, who became anxious when she noticed a bluish discolouration of her urine drainage system. Urine microbiology revealed growth ofProvidencia stuartiiandStaphylococcus aureus. There were no systemic features of infection and, therefore, antibiotics were not prescribed for asymptomatic bacteriuria. This patient was advised to change the urine bag every day, and was prescribed senna to facilitate bowel evacuation. She was reassured that bluish discolouration of the urine drainage tube and bag was a transient, benign phenomenon and not indicative of any underlying pathology. Over the next 7 days, the bluish discolouration gradually faded away. Clinical characteristics of patients who are likely to develop this phenomenon and the underlying biochemical mechanism for bluish discolouration of the urine drainage system are discussed in brief.
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Kasanga, Maisa, Raphael Mukosha, Maika Kasanga, Makomani Siyanga, Steward Mudenda, Benjamin Bisesa Solochi, Misheck Chileshe, et al. "Antimicrobial resistance patterns of bacterial pathogens: their distribution in university teaching hospitals in Zambia." Future Microbiology 16, no. 11 (July 2021): 811–24. http://dx.doi.org/10.2217/fmb-2021-0104.
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Aim: To determine the antimicrobial resistance patterns of bacterial pathogens from urine, blood and wound infections and their distribution by age, sex and location. Materials & methods: A total of 49,168 samples were collected, processed and analyzed. Results: Multidrug resistance was observed in almost all bacterial pathogens in blood urine and wound swabs. In urine and females odds ratio (OR) = 0.864, p = 0.023, OR = 0.909, p = 0.013 urine and neonates were susceptible to antibiotics OR = 0.859, p = 0.003, OR = 0.741, p < 0.001. Ampicillin resistance was above 90% against Escherichia coli in blood, urine and wound swabs. Conclusion: There was a spike in resistance to imipenem, ciprofloxacin and ampicillin against E. coli, Klebsiella pneumoniae, Proteus mirabilis and Proteus species from all three specimen sources.
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Kazakova, Sophia, Natalie McCarthy, James Baggs, Kelly Hatfield, Babatunde Wolford, Babatunde Olubajo, John Jernigan, and Sujan Reddy. "Temporal trends in urine-culture rates in the US acute-care hospitals, 2017–2020." Antimicrobial Stewardship & Healthcare Epidemiology 2, S1 (May 16, 2022): s12. http://dx.doi.org/10.1017/ash.2022.75.
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Background: Previously, we reported decreasing postadmission urine-culture rates in hospitalized patients between 2012 and 2017, indicating a possible decrease in hospital-onset urinary tract infections or changes in diagnostic practices in acute-care hospitals (ACHs). In this study, we re-evaluated the trends using more recent data from 2017–2020 to assess whether new trends in hospital urine-culturing practices had emerged. Method: We conducted a longitudinal analysis of monthly urine-culture rates using microbiology data from 355 ACHs participating in the Premier Healthcare Database in 2017–2020. All cultures from the urinary tract collected on or before day 3 were defined as admission urine cultures and those collected on day 4 or later were defined as postadmission urine cultures. We included discharges from months where a hospital reported at least 1 urine culture with microbiology and antimicrobial susceptibility test results. Annual estimates of rates of admission culture and postadmission urine-culture rates were assessed using general estimating equation models with a negative binomial distribution accounting for hospital-level clustering and adjusting for hospital bed size, teaching status, urban–rural designation, discharge month, and census division. Estimated rate for each year (2018, 2019, and 2020) was compared to previous year’s estimated rate using rate ratios (RRs) and 95% confidence intervals (CIs) generated through the multivariable GEE models. Results: From 2017 to 2020, we included 8.7 million discharges and 1,943,540 urine cultures, of which 299,013 (15.4%) were postadmission urine cultures. In 2017–2020, unadjusted admission culture rates were 20.0, 19.6, 17.9, and 18.2 per 100 discharges respectively; similarly, unadjusted postadmission urine-culture rates were 8.6, 7.8, 7.0, and 7.5 per 1,000 patient days. In the multivariable analysis, adjusting for hospital characteristics, no significant changes in admission urine-culture rates were detected during 2017–2019; however, in 2020, admission urine-culture rates increased 6% compared to 2019 (RR, 1.06; 95% CI, 1.02–1.09) (Fig. 1). Postadmission urine-culture rates decreased 4% in 2018 compared to 2017 (RR, 0.96; 95% CI, 0.91–0.99) and 8% in 2019 compared to 2018 (RR, 0.92; 95% CI, 0.87–0.96). In 2020, postadmission urine-culture rates increased 10% compared to 2019 (RR, 1.10; 95% CI, 1.06–1.14) (Fig. 2). Factors significantly associated with postadmission urine-culture rates included discharge month and hospital bed size. For admission urine cultures, discharge month was the only significant factor. Conclusions: Between 2017–2019, postadmission urine-culture rates continued a decreasing trend, while admission culture rates remained unchanged. However, in 2020 both admission and postadmission urine culture rates increased significantly in comparison to 2019.Funding: NoneDisclosures: None
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Rogenstein, C., J. Worrall, I. Taylor, and J. J. Perry. "P143: Retrospective review of microbiology results in adult patients presenting to the emergency department with acute epididymitis." CJEM 18, S1 (May 2016): S125—S126. http://dx.doi.org/10.1017/cem.2016.317.
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Introduction: North American practice guidelines for empiric antibiotic selection in the treatment of epididymitis are based on very small studies. These guidelines recommend antibiotic selection based on age. This study’s objective was to determine if culture results in a Canadian emergency department population with acute epididymitis support these guidelines. Methods: We conducted an electronic health records review ED patients with a discharge diagnosis of epididymitis. All patients who presented to two emergency department sites of the Ottawa Hospital from 2012 through 2014 were included. Data collected were patient age, urine culture results, results of urine or urethral swab nucleic acid amplification test (NAAT) for gonorrhea or chlamydia, and results of scrotal ultrasound. Ultrasound radiology reports were independently reviewed by two authors and classified as positive, negative, or indeterminate. Results: We identified 379 cases of epididymitis. There were 169 patients aged 18-35 years, and 202 patients over 35 years. The rates of positive urine culture, in the under 35 and over 35 population respectively, were 5% and 42% (p<.0001). The rates of positive NAAT were 10% and 4% (p=.43). Ultrasound was performed in 252 patients; 160 (63%) were positive. There was no significant difference in the rates of positive urine culture or NAAT between the ultrasound-positive patients and patients who had negative, indeterminate, or no ultrasound. Conclusion: Our findings are not concordant with clinical practice guidelines. While the over 35 age group had a statistically higher rate of positive urine culture, the rate of positive NAAT was not different from the younger group. Both urine culture and NAAT are usually negative in the under 35 group. Positive culture rates are not higher in the subgroup of ultrasound “proven” epididymitis. Physicians should exercise clinical judgement in selecting empiric antibiotics for patients with epididymitis; basing choice on patient age alone may not be appropriate.
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Heitkemper, M. M., K. C. Cain, R. J. Shulman, R. L. Burr, C. Ko, E. B. Hollister, N. Callen, J. Zia, C. J. Han, and M. E. Jarrett. "Stool and urine trefoil factor 3 levels: associations with symptoms, intestinal permeability, and microbial diversity in irritable bowel syndrome." Beneficial Microbes 9, no. 3 (April 25, 2018): 345–55. http://dx.doi.org/10.3920/bm2017.0059.
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Previously we showed that urine trefoil factor 3 (TFF3) levels were higher in females with irritable bowel syndrome (IBS) compared to non-IBS females. To assess if TFF3 is associated with symptoms and/or reflect alterations in gastrointestinal permeability and gut microbiota in an IBS population, we correlated stool and urine TFF3 levels with IBS symptoms, intestinal permeability, stool microbial diversity and relative abundance of predominant bacterial families and genera. We also tested the relationship of stool TFF3 to urine TFF3, and compared results based on hormone contraception use. Samples were obtained from 93 females meeting Rome III IBS criteria and completing 4-week symptom diaries. TFF3 levels were measured by ELISA. Permeability was assessed with the urine lactulose/mannitol (L/M) ratio. Stool microbiota was assessed using 16S rRNA. Stool TFF3, but not urine TFF3, was associated positively with diarrhoea and loose stool consistency. Higher stool TFF3 was also associated with lower L/M ratio and microbial diversity. Of the 20 most abundant bacterial families Mogibacteriaceae and Christensenellaceae were inversely related to stool TFF3, with only Christensenellaceae remaining significant after multiple comparison adjustment. There were no significant relationships between stool or urine TFF3 levels and other symptoms, nor between stool and urine levels. In premenopausal females, urine TFF3 levels were higher in those reporting hormone contraception. Collectively these results suggest that higher stool TFF3 levels are associated with IBS symptoms (loose/diarrhoeal stools), lower gut permeability, and altered stool bacteria composition (decreased diversity and decreased Christensenellaceae), which further suggests that TFF3 may be an important marker of host-bacteria interaction.
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LaRocco, Mark T., Jacob Franek, Elizabeth K. Leibach, Alice S. Weissfeld, Colleen S. Kraft, Robert L. Sautter, Vickie Baselski, Debra Rodahl, Edward J. Peterson, and Nancy E. Cornish. "Effectiveness of Preanalytic Practices on Contamination and Diagnostic Accuracy of Urine Cultures: a Laboratory Medicine Best Practices Systematic Review and Meta-analysis." Clinical Microbiology Reviews 29, no. 1 (November 23, 2015): 105–47. http://dx.doi.org/10.1128/cmr.00030-15.
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SUMMARYBackground.Urinary tract infection (UTI) in the United States is the most common bacterial infection, and urine cultures often make up the largest portion of workload for a hospital-based microbiology laboratory. Appropriately managing the factors affecting the preanalytic phase of urine culture contributes significantly to the generation of meaningful culture results that ultimately affect patient diagnosis and management. Urine culture contamination can be reduced with proper techniques for urine collection, preservation, storage, and transport, the major factors affecting the preanalytic phase of urine culture.Objectives.The purposes of this review were to identify and evaluate preanalytic practices associated with urine specimens and to assess their impact on the accuracy of urine culture microbiology. Specific practices included collection methods for men, women, and children; preservation of urine samples in boric acid solutions; and the effect of refrigeration on stored urine. Practice efficacy and effectiveness were measured by two parameters: reduction of urine culture contamination and increased accuracy of patient diagnosis. The CDC Laboratory Medicine Best Practices (LMBP) initiative's systematic review method for assessment of quality improvement (QI) practices was employed. Results were then translated into evidence-based practice guidelines.Search strategy.A search of three electronic bibliographic databases (PubMed, SCOPUS, and CINAHL), as well as hand searching of bibliographies from relevant information sources, for English-language articles published between 1965 and 2014 was conducted.Selection criteria.The search contained the following medical subject headings and key text words: urinary tract infections, UTI, urine/analysis, urine/microbiology, urinalysis, specimen handling, preservation, biological, preservation, boric acid, boric acid/borate, refrigeration, storage, time factors, transportation, transport time, time delay, time factor, timing, urine specimen collection, catheters, indwelling, urinary reservoirs, continent, urinary catheterization, intermittent urethral catheterization, clean voided, midstream, Foley, suprapubic, bacteriological techniques, and microbiological techniques.Main results.Both boric acid and refrigeration adequately preserved urine specimens prior to their processing for up to 24 h. Urine held at room temperature for more than 4 h showed overgrowth of both clinically significant and contaminating microorganisms. The overall strength of this body of evidence, however, was rated as low. For urine specimens collected from women, there was no difference in rates of contamination for midstream urine specimens collected with or without cleansing. The overall strength of this evidence was rated as high. The levels of diagnostic accuracy of midstream urine collection with or without cleansing were similar, although the overall strength of this evidence was rated as low. For urine specimens collected from men, there was a reduction in contamination in favor of midstream clean-catch over first-void specimen collection. The strength of this evidence was rated as high. Only one study compared midstream collection with cleansing to midstream collection without cleansing. Results showed no difference in contamination between the two methods of collection. However, imprecision was due largely to the small event size. The diagnostic accuracy of midstream urine collection from men compared to straight catheterization or suprapubic aspiration was high. However, the overall strength of this body of evidence was rated as low. For urine specimens collected from children and infants, the evidence comparing contamination rates for midstream urine collection with cleansing, midstream collection without cleansing, sterile urine bag collection, and diaper collection pointed to larger reductions in the odds of contamination in favor of midstream collection with cleansing over the other methods of collection. This body of evidence was rated as high. The accuracy of diagnosis of urinary tract infection from midstream clean-catch urine specimens, sterile urine bag specimens, or diaper specimens compared to straight catheterization or suprapubic aspiration was varied.Authors' conclusions.No recommendation for or against is made for delayed processing of urine stored at room temperature, refrigerated, or preserved in boric acid. This does not preclude the use of refrigeration or chemical preservatives in clinical practice. It does indicate, however, that more systematic studies evaluating the utility of these measures are needed. If noninvasive collection is being considered for women, midstream collection with cleansing is recommended, but no recommendation for or against is made for midstream collection without cleansing. If noninvasive collection is being considered for men, midstream collection with cleansing is recommended and collection of first-void urine is not recommended. No recommendation for or against is made for collection of midstream urine without cleansing. If noninvasive collection is being considered for children, midstream collection with cleansing is recommended and collection in sterile urine bags, from diapers, or midstream without cleansing is not recommended. Whether midstream collection with cleansing can be routinely used in place of catheterization or suprapubic aspiration is unclear. The data suggest that midstream collection with cleansing is accurate for the diagnosis of urinary tract infections in infants and children and has higher average accuracy than sterile urine bag collection (data for diaper collection were lacking); however, the overall strength of evidence was low, as multivariate modeling could not be performed, and thus no recommendation for or against can be made.
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Christian, Robbie Lee Anne, Curtis Donskey, and Maria Navas. "659. Evaluation of a Rapid Diagnostic Assay for Early Detection of Bacteriuria." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S302. http://dx.doi.org/10.1093/ofid/ofz360.727.
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Abstract Background Patients with suspected urinary tract infection (UTI) are often prescribed an empiric antibiotic treatment due to delays in obtaining results of urine cultures. The BacterioScan System measures the turbidity of incubating urine specimens to provide a qualitative determination of bacteriuria at a density of >5 × 104 colony-forming units (CFU)/mL within approximately 3 hours. We examined the utility of the BacterioScan assay in predicting bacteriuria and assessed the potential impact of this test to reduce the number of urine cultures processed. Methods Urine samples received for culture in the microbiology laboratory of the Cleveland VA Medical Center were collected daily between September 2018 and December 2018. For each specimen, we performed a bacterioscan diagnostic test and compared it with the result of the traditional culture and urinalysis if available. Urinary cultures were categorized into 4 groups as defined in Figure 1. We compared the sensitivity and specificity of the bacterioscan vs. urinalysis (leukocyte esterase and/or pyuria) results. Results 120 urine samples were tested. As shown in Table 1, the BacterioScan had better sensitivity and specificity than the urinalysis for detection of positive urine cultures. The use of the BacterioScan to rule out UTI could have accurately spared 69 of 120 (57.5%) samples from traditional culture and prevented 26 of 120 (21.6%) from possible misinterpretation as infection due to reporting of growth. BacterioScan resulted in 4 of 31 (12.9%) false negatives, but all occurred when positive cultures were due to viridans streptococci or uropathogens in numbers below 100,000 CFU.ml. Conclusion The BacterioScan system is a rapid diagnostic test that provides early information on urine culture results that could help to avoid overuse of empirical antimicrobials in patients with suspected UTI and decrease the workload of the Microbiology Laboratory. Disclosures All authors: No reported disclosures.
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Shrestha, Anil, Andrew Georgiou, and Nasir Wabe. "Timeliness of Microbiology Test Result Reporting and Association with Outcomes of Adults Hospitalised with Unspecified Pneumonia: A Data Linkage Study." International Journal of Clinical Practice 2022 (July 20, 2022): 1–8. http://dx.doi.org/10.1155/2022/9406499.
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Background. Pneumonia is one of the leading causes of mortality and morbidity worldwide. Microbiology tests play a critical role in the diagnosis of pneumonia. Our study aimed to determine microbiology result reporting times and evaluate their association with outcomes of adult patients (≥18 years) hospitalised with pneumonia. Methods. This is a 3-year (2016–2018) retrospective cohort study in six hospitals in New South Wales, Australia. The study data were obtained by linking hospital and laboratory system databases. Result reporting times including time from admission to the first and the last microbiology test results were determined. The outcome measures were hospital length of stay (LOS) and in-hospital mortality. We fit median and logistic regression to evaluate the association of time-to-first microbiological result with hospital LOS and in-hospital mortality, respectively. Results. A total of 6,298 patients met the inclusion criteria. Of these, 85.3% (n = 5,375) ordered at least one microbiology test. The top 5 microbiology tests were blood culture, urine culture, respiratory polymerase chain reaction (PCR), urine antigen, and sputum culture. The median time-to-first microbiology result was 26 hrs while the median time-to-last test result was 144 hrs. The rate of in-hospital mortality was 5.9% (n = 371). After adjusting for confounders, every 5 hrs increase in the time-to-first microbiology test was associated with an increase of 3.9 hrs in the median hospital LOS [95% Confidence Interval (CI), 3.5 to 4.3; P ≤ 0.001 ]. There was no association between time-to-first microbiology result and in-hospital mortality (OR 1.01; 95% CI 1.00–1.02; P = 0.122 ). Conclusion. Time-to-first microbiology result reporting was significantly associated with hospital LOS but not with in-hospital mortality. Further research should be conducted to understand if improving result reporting times can reduce the length of hospital stay of patients.
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Reischies, Frederike M. J., Reinhard B. Raggam, Juergen Prattes, Robert Krause, Susanne Eigl, Agnes List, Franz Quehenberger, Volker Strenger, Albert Wölfler, and Martin Hoenigl. "Urine Galactomannan-to-Creatinine Ratio for Detection of Invasive Aspergillosis in Patients with Hematological Malignancies." Journal of Clinical Microbiology 54, no. 3 (December 23, 2015): 771–74. http://dx.doi.org/10.1128/jcm.02969-15.
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Galactomannan (GM) testing of urine specimens may provide important advantages, compared to serum testing, such as easy noninvasive sample collection. We evaluated a total of 632 serial urine samples from 71 patients with underlying hematological malignancies and found that the urine GM/creatinine ratio, i.e., (urine GM level × 100)/urine creatinine level, which takes urine dilution into account, reliably detected invasive aspergillosis and may be a promising diagnostic tool for patients with hematological malignancies. (This study has been registered at ClinicalTrials.gov under registration no. NCT01576653.)
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Cantey, Joseph B., Claudia Gaviria-Agudelo, Erin McElvania TeKippe, and Christopher D. Doern. "Lack of Clinical Utility of Urine Gram Stain for Suspected Urinary Tract Infection in Pediatric Patients." Journal of Clinical Microbiology 53, no. 4 (February 4, 2015): 1282–85. http://dx.doi.org/10.1128/jcm.00045-15.
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Urinary tract infection (UTI) is one of the most common infections in children. Urine culture remains the gold standard for diagnosis, but the utility of urine Gram stain relative to urinalysis (UA) is unclear. We reviewed 312 pediatric patients with suspected UTI who had urine culture, UA, and urine Gram stain performed from a single urine specimen. UA was considered positive if ≥10 leukocytes per oil immersion field were seen or if either nitrates or leukocyte esterase testing was positive. Urine Gram stain was considered positive if any organisms were seen. Sensitivity, specificity, and positive and negative predictive values were calculated using urine culture as the gold standard. Thirty-seven (12%) patients had a culture-proven UTI. Compared to urine Gram stain, UA had equal sensitivity (97.3% versus 97.5%) and higher specificity (85% versus 74%). Empirical therapy was prescribed before the Gram stain result was known in 40 (49%) patients and after in 42 (51%) patients. The antibiotics chosen did not differ between the two groups (P= 0.81), nor did they differ for patients with Gram-negative rods on urine Gram stain compared to those with Gram-positive cocci (P= 0.67). From these data, we conclude that UA has excellent negative predictive value that is not enhanced by urine Gram stain and that antibiotic selection did not vary based on the urine Gram stain result. In conclusion, the clinical utility of urine Gram stain does not warrant the time or cost it requires.
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Karlowsky, James A., Judith Steenbergen, and George G. Zhanel. "Microbiology and Preclinical Review of Omadacycline." Clinical Infectious Diseases 69, Supplement_1 (August 1, 2019): S6—S15. http://dx.doi.org/10.1093/cid/ciz395.
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AbstractOmadacycline is a novel aminomethylcycline antimicrobial and semisynthetic derivative of tetracycline. In vitro, omadacycline displays potent activity against gram-positive and many gram-negative bacteria, including methicillin-resistant Staphylococcus aureus, Streptococcus pneumoniae, β-hemolytic streptococci, vancomycin-resistant Enterococcus, and Enterobacteriaceae. Omadacycline is also active against atypical and anaerobic pathogens, including Legionella pneumophila, Mycoplasma spp., Ureaplasma spp., Bacteroides spp., and Clostridioides difficile. This review outlines the microbiology and preclinical studies of omadacycline, including its mechanism of action; spectrum of activity; protein binding; activity in the presence of surfactant, serum, normal, and pH-adjusted urine, or bacterial biofilms; postantibiotic effect; pharmacodynamic properties; and in vitro and in vivo efficacy. The results of in vitro and in vivo animal studies support the observations made in phase III clinical trials and the clinical development of omadacycline.
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Shah, Pratima, Ratna Baral, C. S. Agrawal, Madhab Lamsal, Dharanidhar Baral, and Basudha Khanal. "Urinary Calculi: A Microbiological and Biochemical Analysis at a Tertiary Care Hospital in Eastern Nepal." International Journal of Microbiology 2020 (September 12, 2020): 1–9. http://dx.doi.org/10.1155/2020/8880403.
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Background. The occurrence of urinary tract infection in presence of urolithiasis is frequently noted; however, microbial agents of urolithiasis and their antimicrobial susceptibility patterns remain underinvestigated. This study aimed to identify the microorganisms isolated from urine and stone matrices to determine their antimicrobial susceptibility, to find the association between the pathogens of urine and stone matrices, and to perform the biochemical analysis of stones. Methods. A total of 88 cases of urolithiasis admitted for elective stone removal at Department of surgery, B.P. Koirala Institute of Health Sciences (BPKIHS), were enrolled. Preoperative urine culture and postoperative stone culture were performed. Isolation, identification, and AST were done by the standard microbiological technique. Further qualitative biochemical analysis of stones was also attempted. Result. Among 88 stone formers recruited, culture of urine, whole stone, and nidus yielded the growth of bacteria 44, 32, and 30, respectively. Bacteria isolated from urine culture correlated with those from stone matrices with a sensitivity of 90%, specificity of 79.69%, PPV of 63.64%, and NPV of 95.45%. Escherichia coli (46.7%) was the most common bacteria followed by Klebsiella pneumoniae (16.7%) and Proteus mirabilis (13.3%) from urine and stone cultures. Almost all the uropathogens isolated were susceptible to commonly used antibiotics. Calcium oxalate (84.1%) was common biochemical constituent found in stone formers followed by calcium oxalate + phosphate (8%). Conclusions. The association of microorganism isolated from urine and nidus culture was significant that can predict the source of infective stone; however, in some cases, microorganisms and the antimicrobial susceptibility pattern from urine and nidus were different. This study emphasizes the use of appropriate antimicrobial agents to prevent the regrowth of residual stones and minimize the risk of infectious complications after surgical removal of stones.
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Islaeli, Baiq Nasha, Maruni Wiwin Diarti, and Yudha Anggit Jiwintoro. "PEMANFAATAN LARUTAN GARAM NATRIUM KLORIDA (NaCl) SEBAGAI PENGAWET ALTERNATIF PADA URINE UNTUK PEMERIKSAAN URINE METODE CARIK CELUP." Jurnal Analis Medika Biosains (JAMBS) 6, no. 1 (July 18, 2019): 41. http://dx.doi.org/10.32807/jambs.v6i1.123.
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Pemeriksaan urine dilakukan untuk kepentingan diagnosis, salah satunya adalah mengontrol pengobatan pada pasien DM. Diabetes Mellitus memiliki resiko terjadinya infeksi saluran kemih (ISK).Berdasarkan SOP In Microbiology, sampel urine harus segera diperiksa kurang dari 2 jam setelah pengambilan. Penundaan ini akan meningkatkan pertumbuhan bakteri. Jika terjadi penundaan, sampel urine dapat ditambahkan pengawet. Salah satu pengawet alternatif yang dapat menekan pertumbuhan bakteri adalah garam (NaCl). Tujuan dari penelitian ini adalah untuk mengetahui manfaat larutan garam natrium klorida (NaCl) sebagai pengawet alternatif pada urine untuk pemeriksaan urine metode carik celup. Penelitian ini merupakan penelitian Pra Eksperimen dengan rancangan One Group Pretest Posttest. Sampel urine responden ditambahkan larutan garam NaCl konsentrasi 3,5%, 4,0%, dan 4,5% lalu didiamkan selama 12 jam. Hasil penelitian menunjukkan bahwa larutan garam konsentrasi 3,5%, 4,0%, dan 4,5% mampu mempertahankan kadar leukosit esterase dan nitrit pada urine yang didiamkan selama 12 jam. Jumlah eritrosit dalam urine dapat dipertahankan dengan penambahan larutan garam konsentrasi 3,5% dan 4,0%. Sedangkan penambahan larutan garam NaCl tidak berpengaruh terhadap glukosa urine yang didiamkan selama 12 jam. Kesimpulan yang dapat diambil dari penelitian ini adalah larutan garam NaCl konsentrasi 3,5% dan 4,0% dapat dijadikan sebagai pengawet alternatif pada urine untuk parameter leukosit esterase, nitrit, dan eritrosit.
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Íñigo, Melania, Andreu Coello, Gema Fernández-Rivas, Belén Rivaya, Jessica Hidalgo, María Dolores Quesada, and Vicente Ausina. "Direct Identification of Urinary Tract Pathogens from Urine Samples, Combining Urine Screening Methods and Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry." Journal of Clinical Microbiology 54, no. 4 (January 27, 2016): 988–93. http://dx.doi.org/10.1128/jcm.02832-15.
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Early diagnosis of urinary tract infections (UTIs) is essential to avoid inadequate or unnecessary empirical antibiotic therapy. Microbiological confirmation takes 24 to 48 h. The use of screening methods, such as cytometry and automated microscopic analysis of urine sediment, allows the rapid prediction of negative samples. In addition, matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) is a widely established technique in clinical microbiology laboratories used to identify microorganisms. We evaluated the ability of MALDI-TOF MS to identify microorganisms from direct urine samples and the predictive value of automated analyzers for the identification of microorganisms in urine by MALDI-TOF MS. A total of 451 urine samples from patients with suspected UTIs were first analyzed using the Sysmex UF-1000iflow cytometer, an automatic sediment analyzer with microscopy (SediMax), culture, and then processed by MALDI-TOF MS with a simple triple-centrifuged procedure to obtain a pellet that was washed and centrifuged and finally applied directly to the MALDI-TOF MS plate. The organisms in 336 samples were correctly identified, mainly those with Gram-negative bacteria (86.10%). No microorganisms were misidentified, and noCandidaspp. were correctly identified. Regarding the data from autoanalyzers, the best bacteriuria cutoffs were 1,000 and 200 U/μl for UF-1000iand SediMax, respectively. It was concluded that the combination of a urine screening method and MALDI-TOF MS provided a reliable identification from urine samples, especially in those containing Gram-negative bacteria.
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Ullah, Ihsan, Aamir Hussain, Humera Adeeb, and Mubarak Zeb. "Frequency and Antimicrobial Susceptibility Pattern of Gram-Negative Bacilli Isolated From Urine Specimens at a Tertiary Care Setting." Journal of Gandhara Medical and Dental Science 9, no. 1 (January 7, 2022): 15–19. http://dx.doi.org/10.37762/jgmds.9-1.126.
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OBJECTIVES: To find out the frequency and pattern of conventional antibiotic susceptibility of gram-negative bacilli cultured from urine specimens of patients at a tertiary care setting. METHODOLOGY: This study was conducted at the Microbiology Department of Combined Military Hospital Multan from June 2016 to May 2017. The data in this retrospective descriptive study was collected from urine culture records of the Microbiology Department, CMH Multan. Only those urine specimens who revealed positive gram-negative bacilli cultures were included in the study. Drug susceptibility patterns of these isolates were recorded against routinely used antibiotics (e.g. Nitrofurantoin, Imipenem, Sulbactum-cefoperazone, Gentamicin and Ciprofloxacin) and evaluated accordingly. RESULTS: A total of 1703 urine specimens were submitted for culture and antibiotics susceptibility testing during the period of study. A total of 128 specimens showed growth of gram-negative rods. Imipenem (95% sensitivity), Sulbactam- Cefoperazone (88% sensitivity) and Nitrofurantoin (87% sensitivity) were highly effective antibiotics against the cultured gram-negative bacilli in the study. CONCLUSION: This study showed that E. coli is the commonest cause of urinary tract infection (UTIs), followed by Klebsiella and Enterobacter species among gram-negative bacilli in our set up. In-vitro efficacy of Imipenem, Sulbactam- Cefoperazone and Nitrofurantoin was found to be the highest against these gram-negative bacilli as compared to other antimicrobials. On the contrary, in-vitro efficacy of ciprofloxacin and gentamycin was found to be extremely low.
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Silver, Samuel A., Laura Baillie, and Andrew E. Simor. "Positive Urine Cultures: A Major Cause of Inappropriate Antimicrobial Use in Hospitals?" Canadian Journal of Infectious Diseases and Medical Microbiology 20, no. 4 (2009): 107–11. http://dx.doi.org/10.1155/2009/702545.
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INTRODUCTION: Urine specimens are among the most common samples submitted for culture to microbiology laboratories. The objectives of the present study were to describe the indications for obtaining urine cultures in a cohort of hospitalized patients, and to determine the appropriateness of antimicrobial therapy in response to urine culture results.METHODS: The study was performed at a teaching hospital with an adjoining long-term care facility from June 1 to July 31, 2006. The medical records of nonpregnant adult patients with and without bacteriuria were reviewed. A symptomatic urinary tract infection was defined as the presence of bacteriuria in a patient with fever or urinary symptoms; asymptomatic bacteriuria was defined as bacteriuria without urinary symptoms and no infection evident at another site.RESULTS: Medical records of 335 eligible patients (64% male; mean age 68 years) were reviewed, including all 137 with bacteriuria, and 198 with negative urine cultures. In total, 51% of the urine specimens were obtained from an indwelling urinary catheter, and 28% were voided urine samples. Confusion (57%) and fever (36%) were the most common indications noted for obtaining the urine cultures. Only 34 patients (25% of those with positive urine cultures) met the criteria for a symptomatic urinary tract infection; 67 (49%) had asymptomatic bacteriuria and 36 (26%) had infection at a nonurinary site. Of those with asymptomatic bacteriuria, 64% received antimicrobial therapy for a total of 347 days. Confused patients with asymptomatic bacteriuria were more likely to be treated than were bacteriuric patients without altered mental status (OR 1.8, 95% CI 1.2 to 4.1; P=0.03).CONCLUSIONS: Urine cultures are frequently obtained from hospitalizedpatients,evenintheabsenceofurinarysymptoms.Asymptomatic bacteriuria is often treated in these patients, and accounts for a substantial burden of inappropriate antimicrobial use in hospitals. Effective strategies to improve urine culture ordering and antimicrobial utilization in hospitals need to be implemented.
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Price, Travis K., Tanaka Dune, Evann E. Hilt, Krystal J. Thomas-White, Stephanie Kliethermes, Cynthia Brincat, Linda Brubaker, Alan J. Wolfe, Elizabeth R. Mueller, and Paul C. Schreckenberger. "The Clinical Urine Culture: Enhanced Techniques Improve Detection of Clinically Relevant Microorganisms." Journal of Clinical Microbiology 54, no. 5 (March 9, 2016): 1216–22. http://dx.doi.org/10.1128/jcm.00044-16.
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Enhanced quantitative urine culture (EQUC) detects live microorganisms in the vast majority of urine specimens reported as “no growth” by the standard urine culture protocol. Here, we evaluated an expanded set of EQUC conditions (expanded-spectrum EQUC) to identify an optimal version that provides a more complete description of uropathogens in women experiencing urinary tract infection (UTI)-like symptoms. One hundred fifty adult urogynecology patient-participants were characterized using a self-completed validated UTI symptom assessment (UTISA) questionnaire and asked “Do you feel you have a UTI?” Women responding negatively were recruited into the no-UTI cohort, while women responding affirmatively were recruited into the UTI cohort; the latter cohort was reassessed with the UTISA questionnaire 3 to 7 days later. Baseline catheterized urine samples were plated using both standard urine culture and expanded-spectrum EQUC protocols: standard urine culture inoculated at 1 μl onto 2 agars incubated aerobically; expanded-spectrum EQUC inoculated at three different volumes of urine onto 7 combinations of agars and environments. Compared to expanded-spectrum EQUC, standard urine culture missed 67% of uropathogens overall and 50% in participants with severe urinary symptoms. Thirty-six percent of participants with missed uropathogens reported no symptom resolution after treatment by standard urine culture results. Optimal detection of uropathogens could be achieved using the following: 100 μl of urine plated onto blood (blood agar plate [BAP]), colistin-nalidixic acid (CNA), and MacConkey agars in 5% CO2for 48 h. This streamlined EQUC protocol achieved 84% uropathogen detection relative to 33% detection by standard urine culture. The streamlined EQUC protocol improves detection of uropathogens that are likely relevant for symptomatic women, giving clinicians the opportunity to receive additional information not currently reported using standard urine culture techniques.
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Ciragil, Pınar, Ergul Belge Kurutas, and Meral Miraloglu. "New Markers: Urine Xanthine Oxidase and Myeloperoxidase in the Early Detection of Urinary Tract Infection." Disease Markers 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/269362.
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Objectives.The aim of this study was to evaluate if xanthine oxidase and myeloperoxidase levels quantitation method may alternate routine culture method, which takes more time in the diagnosis of urinary tract infections.Material and Methods.Five hundred and forty-nine outpatients who had admitted to Clinic Microbiology Laboratory were included in the study. The microorganisms were identified by using VITEK System. The urine specimens that were negative from the quantitative urine culture were used as controls. The activities of MPO and XO in spot urine were measured by spectrophotometric method.Results.Through the urine cultures, 167 bacteria were isolated from 163 urine specimens; 386 cultures yielded no bacterial growth.E. coliwas the most frequent pathogen. In infection withE. coliboth XO and MPO levels were increased the most. The sensitivity, specificity, positive predictive value, and negative predictive value for XO were 100%, 100%, 100%, and 100%, respectively. These values for MPO were 87%, 100%, 100%, and 94%, respectively.Conclusion.These data obtained suggest that urine XO and MPO levels may be new markers in the early detection of UTI.
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Cannon, Harold J., Edward S. Goetz, Ayser C. Hamoudi, and Mario J. Marcon. "Rapid screening and microbiologic processing of pediatric urine specimens." Diagnostic Microbiology and Infectious Disease 4, no. 1 (January 1986): 11–17. http://dx.doi.org/10.1016/0732-8893(86)90051-9.
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Schmidt, Jessica, Viktoria Lindemann, Monica Olsen, Benedikt Cramer, and Hans-Ulrich Humpf. "Dried urine spots as sampling technique for multi-mycotoxin analysis in human urine." Mycotoxin Research 37, no. 2 (February 26, 2021): 129–40. http://dx.doi.org/10.1007/s12550-021-00423-1.
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AbstractA simple and effective approach for HPLC-MS/MS based multi-mycotoxin analysis in human urine samples was developed by application of dried urine spots (DUS) as alternative on-site sampling strategy. The newly developed method enables the detection and quantitation of 14 relevant mycotoxins and mycotoxin metabolites, including citrinin (CIT), dihydrocitrinone (DH-CIT), deoxynivalenol (DON), fumonisin B1 (FB1), T-2 Toxin (T-2), HT-2 Toxin (HT-2), ochratoxin A (OTA), 2′R-ochratoxin A (2′R-OTA), ochratoxin α (OTα), tenuazonic acid and allo-tenuazonic acid (TeA + allo-TeA), zearalenone (ZEN), zearalanone (ZAN), α-zearalenol (α-ZEL), and β-zearalenol (β-ZEL). Besides the spotting procedure, sample preparation includes enzymatic cleavage of glucuronic acid conjugates and stable isotope dilution analysis. Method validation revealed low limits of detection in the range of pg/mL urine and excellent apparent recovery rates for most analytes. Stability investigation of DUS displayed no or only slight decrease of the analyte concentration over a period of 28 days at room temperature. The new method was applied to the analysis of a set of urine samples (n = 91) from a Swedish cohort. The four analytes, DH-CIT, DON, OTA, and TeA + allo-TeA, could be detected and quantified in amounts ranging from 0.06 to 0.97 ng/mL, 3.03 to 136 ng/mL, 0.013 to 0.434 ng/mL and from 0.36 to 47 ng/mL in 38.5%, 70.3%, 68.1%, and 94.5% of the samples, respectively. Additional analysis of these urine samples with an established dilute and shoot (DaS) approach displayed a high consistency of the results obtained with both methods. However, due to higher sensitivity, a larger number of positive samples were observed using the DUS method consequently providing a suitable approach for human biomonitoring of mycotoxin exposure.
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Sheppard, Carmen L., Timothy G. Harrison, Michael D. Smith, and Robert C. George. "Development of a sensitive, multiplexed immunoassay using xMAP beads for detection of serotype-specific Streptococcus pneumoniae antigen in urine samples." Journal of Medical Microbiology 60, no. 1 (January 1, 2011): 49–55. http://dx.doi.org/10.1099/jmm.0.023150-0.
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In support of the surveillance of pneumococcal infections in the era of conjugate vaccines, a sensitive and specific multiplex immunoassay using xMAP beads has been developed for direct detection of pneumococcal serotype-specific polysaccharides in clinical samples, particularly urine. The assay was tested on panels of spiked urine specimens, clinical urine specimens and bacterial isolates. Each of the 14 serotypes in the multiplex assay can be detected to 0.1 ng purified polysaccharide ml−1, or less. Testing of a panel of urine specimens from patients with culture-confirmed pneumococcal or non-pneumococcal disease indicated that the multiplex assay is both sensitive and specific. The correct pneumococcal serotype was identified directly from urine in 46/58 (79.3 %) patients who had a contemporaneous blood culture isolate of a multiplex assay serotype. Furthermore, the specificity of the assay on this panel of samples was 99.3 % (145/146). This multiplex assay could be useful, in conjunction with the pneumococcal screening test Binax NOW, in urine for diagnosis of pneumococcal disease and the identification of the aetiological serotype, and potentially be of benefit in culture-negative patients.
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Dorn, G. L. "Microbial stabilization of antibiotic-containing urine samples by using the FLORA-STAT urine transport system." Journal of Clinical Microbiology 29, no. 10 (1991): 2169–74. http://dx.doi.org/10.1128/jcm.29.10.2169-2174.1991.
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Martineau, Francis, François J. Picard, Christian Ménard, Paul H. Roy, Marc Ouellette, and Michel G. Bergeron. "Development of a Rapid PCR Assay Specific forStaphylococcus saprophyticus and Application to Direct Detection from Urine Samples." Journal of Clinical Microbiology 38, no. 9 (2000): 3280–84. http://dx.doi.org/10.1128/jcm.38.9.3280-3284.2000.
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Staphylococcus saprophyticus is one of the most frequently encountered microorganisms associated with acute urinary tract infections (UTIs) in young, sexually active female outpatients. Conventional identification methods based on biochemical characteristics can efficiently identify S. saprophyticus, but the rapidities of these methods need to be improved. Rapid and direct identification of this bacterium from urine samples would be useful to improve time required for the diagnosis of S. saprophyticus infections in the clinical microbiology laboratory. We have developed a PCR-based assay for the specific detection ofS. saprophyticus. An arbitrarily primed PCR amplification product of 380 bp specific for S. saprophyticus was sequenced and used to design a set of S. saprophyticus-specific PCR amplification primers. The PCR assay was specific for S. saprophyticus when tested with DNA from 49 gram-positive and 31 gram-negative bacterial species. This assay was also able to amplify efficiently DNA from all 60 strains of S. saprophyticus from various origins tested. This assay was adapted for direct detection from urine samples. The sensitivity levels achieved with urine samples was 19 CFU with 30 cycles of amplification and 0.5 CFU with 40 cycles of amplification. This PCR assay for the specific detection of S. saprophyticus is simple and rapid (approximately 90 min, including the time for urine specimen preparation).
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Humphries, Romney M., and Jennifer Dien Bard. "Point-Counterpoint: Reflex Cultures Reduce Laboratory Workload and Improve Antimicrobial Stewardship in Patients Suspected of Having Urinary Tract Infections." Journal of Clinical Microbiology 54, no. 2 (December 9, 2015): 254–58. http://dx.doi.org/10.1128/jcm.03021-15.
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Urinary tract infections (UTIs) are frequent and lead to a large number of clinical encounters. A common management strategy for patients suspected of having a urinary tract infection is to test for pyuria and bacteria by urine analysis (UA) of midstream urine, with initiation of antibiotic therapy and urine culture if one or both tests are positive. Although this practice was first used in an outpatient setting with midstream urine samples, some institutions allow its use in the management of catheterized patients. The ideas behind the reflex urine culture are to limit laboratory workload by not performing culture on negative specimens and to improve antimicrobial stewardship by not giving antimicrobials to patients with negative UA results. The questions are, first, whether reflex urine culture reduces workloads significantly and, second, whether it improves antimicrobial stewardship in the era of increasing numbers of urinary tract infections due to extensively drug-resistant Gram-negative bacilli. Romney Humphries from UCLA supports the idea that reflex urine cultures are of value and describes what reflex parameters are most useful, while Jennifer Dien Bard of Children's Hospital Los Angeles discusses their limitations.
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Parajuli, Sharmila, and B. Thapa. "Microbiology of Urinary Tract Infection and the Status of Urinary Isolates in Pregnant Women." Medical Journal of Shree Birendra Hospital 13, no. 2 (August 3, 2015): 20–24. http://dx.doi.org/10.3126/mjsbh.v13i2.13111.
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Introduction: Urinary tract infection (UTI) is one of the most frequently encountered problems owing to significant number of patients needing hospitalization during pregnancy. The incidence of UTI in pregnant women is reported to be high up to 7-8%.Methods: This is a prospective study conducted in Valley Maternity Hospital during a period of 6 months (Jan 2011 to June 2011). 520 MSU (Mid stream urine samples) from pregnant women clinically suspected of urine infection were evaluated by urine dipstick analysis, microscopic and culture method. The isolates were identified and antibiotic sensitivity pattern was determined by standard protocol.Results: The majority of the patients were in-between the age group of 20-30years- 338cases (65%) and these patients usually presented in the first trimester of pregnancy- 317cases (60.96%). Out of the 520 clinically suspected UTI cases, 232 (44.61%) was culture positive. Out of the culture positive cases; Escherichia coli (E.coli) was the most common accounting for a total of 144cases (80%). Nitrofurantoin was found to be the most effective drug against the gram negative (Gm-ve) bacteria. Similarly, Ampicillin, Amoxycillin and Cloxacillin were found to be effective agent against gram positive (Gm+ve) bacteria.Conclusions: Screening for bacteriuria is recommended among all pregnant women at the first prenatal visit and in the subsequent trimesters of pregnancy. Prompt treatment of symptomatic UTI and asymptomatic bacteriuria is required in pregnant women to avoid complications like preterm birth, low birth weight and increased perinatal mortality.
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Mejuto, Patricia, Mariam Luengo, and Julio Díaz-Gigante. "Automated Flow Cytometry: An Alternative to Urine Culture in a Routine Clinical Microbiology Laboratory?" International Journal of Microbiology 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/8532736.
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The urine culture is the “gold standard” for the diagnosis of urinary tract infections (UTI) but constitutes a significant workload in the routine clinical laboratory. Due to the high percentage of negative results, there is a need for an efficient screening method, with a high negative predictive value (NPV) that could reduce the number of unnecessary culture tests. With the purpose of improving the efficiency of laboratory work, several methods for screening out the culture-negative samples have been developed, but none of them has shown adequate sensitivity (SE) and high NPV. Many authors show data about the efficacy of flow cytometry in the routine clinical laboratory. The aim of this article is to review and discuss the current literature on the feasibility of urine flow cytometry (UFC) and its utility as an alternative analytical technique in urinalysis.
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Hazen, Kevin C., Gordon W. Theisz, and Susan A. Howell. "Chronic Urinary Tract Infection Due toCandida utilis." Journal of Clinical Microbiology 37, no. 3 (1999): 824–27. http://dx.doi.org/10.1128/jcm.37.3.824-827.1999.
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An elderly male was seen at an outpatient urology clinic over a period of 3 years with repeat urine specimens containing 104 to 105 CFU of a “Candidaspecies, not C. albicans.” The urine specimens were described as infected due to the presence of pyuria, but no antifungal therapy was administered. On two occasions, the patient presented to the emergency room and urine specimens were sent to the clinical microbiology laboratory. On both occasions, a yeast was isolated at concentrations of >105 CFU/ml. The organism was identified as the anamorphic yeast Candida utilis (teleomorph:Pichia jadinii) by conventional methods. Molecular methods, including karyotyping and restriction enzyme analysis, confirmed that the isolates were identical and were C. utilis. The patient developed benign prostatic hypertrophy and chronic obstructive pulmonary disease during the 3-year course. This report is the first demonstration of the isolation of the industrially important yeastC. utilis from a urinary tract infection. In the present case, the organism was associated with chronic, symptomatic disease. The significance of this unusual, low-virulence isolate from a case of urinary tract infection is discussed.
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Van Gerrewey, Thijs, Christophe El-Nakhel, Stefania De Pascale, Jolien De Paepe, Peter Clauwaert, Frederiek-Maarten Kerckhof, Nico Boon, and Danny Geelen. "Root-Associated Bacterial Community Shifts in Hydroponic Lettuce Cultured with Urine-Derived Fertilizer." Microorganisms 9, no. 6 (June 18, 2021): 1326. http://dx.doi.org/10.3390/microorganisms9061326.
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Recovery of nutrients from source-separated urine can truncate our dependency on synthetic fertilizers, contributing to more sustainable food production. Urine-derived fertilizers have been successfully applied in soilless cultures. However, little is known about the adaptation of the plant to the nutrient environment. This study investigated the impact of urine-derived fertilizers on plant performance and the root-associated bacterial community of hydroponically grown lettuce (Lactuca sativa L.). Shoot biomass, chlorophyll, phenolic, antioxidant, and mineral content were associated with shifts in the root-associated bacterial community structures. K-struvite, a high-performing urine-derived fertilizer, supported root-associated bacterial communities that overlapped most strongly with control NPK fertilizer. Contrarily, lettuce performed poorly with electrodialysis (ED) concentrate and hydrolyzed urine and hosted distinct root-associated bacterial communities. Comparing the identified operational taxonomic units (OTU) across the fertilizer conditions revealed strong correlations between specific bacterial genera and the plant physiological characteristics, salinity, and NO3-/NH4+ ratio. The root-associated bacterial community networks of K-struvite and NPK control fertilized plants displayed fewer nodes and node edges, suggesting that good plant growth performance does not require highly complex ecological interactions in hydroponic growth conditions.
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Michel, Pierre A., Christine Lascols, Jay E. Gee, Linda M. Weigel, and David Sue. "Rapid Filter-Based Detection and Culture of Burkholderia pseudomallei from Small Volumes of Urine." Journal of Clinical Microbiology 55, no. 9 (June 21, 2017): 2698–707. http://dx.doi.org/10.1128/jcm.00764-17.
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ABSTRACTClinical outcomes of melioidosis patients improve when the infecting agent,Burkholderia pseudomallei, is rapidly detected and identified by laboratory testing. Detection ofB. pseudomalleiDNA or recovery of the pathogen by culture from urine can support a diagnosis of melioidosis and guide patient care. Two new methods, designated filter-capture DNA isolation (FCDI) and filter cellular recovery (FCR), were developed to increase the sensitivity of detection and recovery of viableB. pseudomalleicells from small volumes (0.45 ml) of urine. DNA from eight strains ofB. pseudomalleithat were spiked into synthetic urine at low concentrations (1 × 102CFU/ml) was detected in FCDI cell lysates using real-time PCR with greater consistency than with preparations from a QIAamp DNA Blood minikit. The FCR method showed greaterB. pseudomalleidetection sensitivity than conventional urine culture methods and resulted in typical colony growth at 24 h from as few as 1 × 102CFU/ml. In addition, the FCR method does not rely on precipitation of a urine pellet by centrifugation and requires a smaller volume of urine. The FCDI and FCR methods described here could improve time-to-results and decrease the number of negativeB. pseudomalleireports that are currently observed from urine culture as a consequence of samples containing low or variable bacterial cell concentrations.
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Morré, Servaas A., Irene G. M. van Valkengoed, Afke de Jong, A. Joan P. Boeke, Jacques T. M. van Eijk, Chris J. L. M. Meijer, and Adriaan J. C. van den Brule. "Mailed, Home-Obtained Urine Specimens: a Reliable Screening Approach for Detecting Asymptomatic Chlamydia trachomatis Infections." Journal of Clinical Microbiology 37, no. 4 (1999): 976–80. http://dx.doi.org/10.1128/jcm.37.4.976-980.1999.
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The use of mailed, home-obtained urine specimens could facilitate screening programs for the detection of asymptomatic Chlamydia trachomatis infections. Since transport time could have an adverse effect on the sensitivity of C. trachomatisdetection by PCR, the influence of DNA degradation on amplification was monitored over the course of 1 week. Therefore, urine specimens were aliquoted on the day of collection or arrival. Two groups of urine specimens were investigated. Group I contains first-void C. trachomatis-positive and -negative urine samples. DNA degradation was monitored in group I samples for 7 days at room temperature (RT) and at 4°C by amplifying different lengths of the human β-globin gene and the C. trachomatis plasmid target. DNA degradation was observed only for the larger human β-globin fragments at days 5 to 7 at RT. In contrast, at 4°C all targets could be amplified. Urine specimens were also frozen and thawed before aliquoting to mimic freezing during transport. This resulted in a lower sensitivity for the detection of C. trachomatis after thawing and 3 to 4 days at RT. In addition, mailed, home-obtained C. trachomatis-positive urine specimens (group II) were analyzed for 7 days after arrival by two commercially available C. trachomatis detection systems (PCR and ligase chain reaction [LCR]). The C. trachomatis plasmid target in mailed, home-obtained urine specimens could be amplified by both PCR and LCR after 1 week of storage and/or transport at RT. In conclusion, our findings indicate that mailed, home-obtained urine specimens are suitable for the sensitive detection of asymptomatic C. trachomatis infections by amplification methods, even if the transport time is up to 1 week at RT. These findings support the feasibility and validity of screening programs based on mailed, home-obtained urine specimens. Larger studies should be initiated to confirm our results.
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Ravinder, P. T., S. C. Parija, and K. S. V. K. Subba Rao. "Urinary Hydatid Antigen Detection by Coagglutination, a Cost-Effective and Rapid Test for Diagnosis of Cystic Echinococcosis in a Rural or Field Setting." Journal of Clinical Microbiology 38, no. 8 (2000): 2972–74. http://dx.doi.org/10.1128/jcm.38.8.2972-2974.2000.
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We describe here coagglutination (Co-A), a rapid slide agglutination test for the detection of hydatid antigen in the urine for the diagnosis of cystic echinococcosis (CE). Paired urine and serum samples were collected from 16 patients with surgically confirmed CE, 10 patients with ultrasound-proven CE, 14 patients with clinically diagnosed CE, 24 patients with various parasitic diseases other than CE, and 25 healthy control subjects. Co-A detected excreted hydatid antigen in the concentrated urine of 7 of 16 (43.75%) surgically confirmed cases, 6 of 10 (60%) ultrasound-proven cases, and 8 of 14 (57.14%) clinically diagnosed cases of CE. A false-positive reaction was observed with 12.50% of control urine specimens from patients with parasitic diseases other than CE and 12% of urine samples from healthy controls. The circulating antigen was detected in the serum in 13 of 16 (81.25%) surgically confirmed cases, 6 of 10 (60%) ultrasound-proven cases, and 13 of 14 (92.86%) clinically diagnosed cases of CE. False-positive reactions were observed with three sera (12.5%) from controls with other parasitic diseases. The low sensitivity of Co-A for detection of antigen in the urine of a patient whose serum was positive for the antigen is possibly due to low levels of antigen in the urine. Unlike the collection of blood for serum, which is an invasive procedure and also requires technical expertise and disposable syringes, urine can be collected easily and frequently without causing any inconvenience to the patient. Urine as a clinical specimen alternative to serum would be immensely useful in the diagnosis of CE, particularly in a rural or field setting. In such situations as well as in poorly equipped laboratories, Co-A has the potential to be used as a simple, rapid, and economical slide agglutination test for detection of urinary hydatid antigen in the diagnosis of CE.