Accurate and fast urinalysis in febrile patients by flow cytometry

Foppie J. de Boer, Elske Gieteling, Heidi van Egmond-Kreileman, Bijan Moshaver, Sjef J.C.M. van der Leur, Coen A. Stegeman, Paul H.P. Groeneveld

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: The urine culture is worldwide accepted as the gold standard in diagnosing urinary tract infections, but is time consuming and costly, other methods are fast but moderately reliable. We investigated whether counting the number of bacteria by flow cytometry could be a fast and accurate method to analyze urine samples in febrile patients at the emergency department (ED)., METHODS: Urine samples were obtained from 140 febrile patients at the ED. Urinalysis was performed according to standard procedures. Flow cytometric analysis for bacteria was performed with the Accuri C6 flow cytometer. Diagnostic values were determined at various cut-off points by using urine culture as the gold standard., RESULTS: The highest diagnostic accuracy of urinalysis of bacteria was obtained with flow cytometric analysis (AUC of 0.96). The best cut-off value for bacteria counted by flow cytometry based on the ROC-curve was 3.72x106 bacteria/mL, this resulted in a sensitivity of 94.7% and a specificity of 88.2%., CONCLUSIONS: Counting bacteria by flow cytometry has the highest diagnostic accuracy and is superior to other methods in urinalysis in febrile patients in the ED when using urine culture as the gold standard.
Original languageEnglish
Pages (from-to)380-387
Number of pages8
JournalInfectious Diseases
Volume49
Issue number5
DOIs
Publication statusPublished - 4 May 2017

Cite this

de Boer, F. J., Gieteling, E., van Egmond-Kreileman, H., Moshaver, B., van der Leur, S. J. C. M., Stegeman, C. A., & Groeneveld, P. H. P. (2017). Accurate and fast urinalysis in febrile patients by flow cytometry. Infectious Diseases, 49(5), 380-387. https://doi.org/10.1080/23744235.2016.1274048
de Boer, Foppie J. ; Gieteling, Elske ; van Egmond-Kreileman, Heidi ; Moshaver, Bijan ; van der Leur, Sjef J.C.M. ; Stegeman, Coen A. ; Groeneveld, Paul H.P. / Accurate and fast urinalysis in febrile patients by flow cytometry. In: Infectious Diseases. 2017 ; Vol. 49, No. 5. pp. 380-387.
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abstract = "BACKGROUND: The urine culture is worldwide accepted as the gold standard in diagnosing urinary tract infections, but is time consuming and costly, other methods are fast but moderately reliable. We investigated whether counting the number of bacteria by flow cytometry could be a fast and accurate method to analyze urine samples in febrile patients at the emergency department (ED)., METHODS: Urine samples were obtained from 140 febrile patients at the ED. Urinalysis was performed according to standard procedures. Flow cytometric analysis for bacteria was performed with the Accuri C6 flow cytometer. Diagnostic values were determined at various cut-off points by using urine culture as the gold standard., RESULTS: The highest diagnostic accuracy of urinalysis of bacteria was obtained with flow cytometric analysis (AUC of 0.96). The best cut-off value for bacteria counted by flow cytometry based on the ROC-curve was 3.72x106 bacteria/mL, this resulted in a sensitivity of 94.7{\%} and a specificity of 88.2{\%}., CONCLUSIONS: Counting bacteria by flow cytometry has the highest diagnostic accuracy and is superior to other methods in urinalysis in febrile patients in the ED when using urine culture as the gold standard.",
keywords = "Accuri C6, Gram stain, emergency department, fever, flow cytometry, urinary dipstick, urinary sediment, urinary tract infection",
author = "{de Boer}, {Foppie J.} and Elske Gieteling and {van Egmond-Kreileman}, Heidi and Bijan Moshaver and {van der Leur}, {Sjef J.C.M.} and Stegeman, {Coen A.} and Groeneveld, {Paul H.P.}",
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de Boer, FJ, Gieteling, E, van Egmond-Kreileman, H, Moshaver, B, van der Leur, SJCM, Stegeman, CA & Groeneveld, PHP 2017, 'Accurate and fast urinalysis in febrile patients by flow cytometry' Infectious Diseases, vol. 49, no. 5, pp. 380-387. https://doi.org/10.1080/23744235.2016.1274048

Accurate and fast urinalysis in febrile patients by flow cytometry. / de Boer, Foppie J.; Gieteling, Elske; van Egmond-Kreileman, Heidi; Moshaver, Bijan; van der Leur, Sjef J.C.M.; Stegeman, Coen A.; Groeneveld, Paul H.P.

In: Infectious Diseases, Vol. 49, No. 5, 04.05.2017, p. 380-387.

Research output: Contribution to journalArticleAcademicpeer-review

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AU - de Boer, Foppie J.

AU - Gieteling, Elske

AU - van Egmond-Kreileman, Heidi

AU - Moshaver, Bijan

AU - van der Leur, Sjef J.C.M.

AU - Stegeman, Coen A.

AU - Groeneveld, Paul H.P.

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N2 - BACKGROUND: The urine culture is worldwide accepted as the gold standard in diagnosing urinary tract infections, but is time consuming and costly, other methods are fast but moderately reliable. We investigated whether counting the number of bacteria by flow cytometry could be a fast and accurate method to analyze urine samples in febrile patients at the emergency department (ED)., METHODS: Urine samples were obtained from 140 febrile patients at the ED. Urinalysis was performed according to standard procedures. Flow cytometric analysis for bacteria was performed with the Accuri C6 flow cytometer. Diagnostic values were determined at various cut-off points by using urine culture as the gold standard., RESULTS: The highest diagnostic accuracy of urinalysis of bacteria was obtained with flow cytometric analysis (AUC of 0.96). The best cut-off value for bacteria counted by flow cytometry based on the ROC-curve was 3.72x106 bacteria/mL, this resulted in a sensitivity of 94.7% and a specificity of 88.2%., CONCLUSIONS: Counting bacteria by flow cytometry has the highest diagnostic accuracy and is superior to other methods in urinalysis in febrile patients in the ED when using urine culture as the gold standard.

AB - BACKGROUND: The urine culture is worldwide accepted as the gold standard in diagnosing urinary tract infections, but is time consuming and costly, other methods are fast but moderately reliable. We investigated whether counting the number of bacteria by flow cytometry could be a fast and accurate method to analyze urine samples in febrile patients at the emergency department (ED)., METHODS: Urine samples were obtained from 140 febrile patients at the ED. Urinalysis was performed according to standard procedures. Flow cytometric analysis for bacteria was performed with the Accuri C6 flow cytometer. Diagnostic values were determined at various cut-off points by using urine culture as the gold standard., RESULTS: The highest diagnostic accuracy of urinalysis of bacteria was obtained with flow cytometric analysis (AUC of 0.96). The best cut-off value for bacteria counted by flow cytometry based on the ROC-curve was 3.72x106 bacteria/mL, this resulted in a sensitivity of 94.7% and a specificity of 88.2%., CONCLUSIONS: Counting bacteria by flow cytometry has the highest diagnostic accuracy and is superior to other methods in urinalysis in febrile patients in the ED when using urine culture as the gold standard.

KW - Accuri C6

KW - Gram stain

KW - emergency department

KW - fever

KW - flow cytometry

KW - urinary dipstick

KW - urinary sediment

KW - urinary tract infection

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SN - 2374-4235

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de Boer FJ, Gieteling E, van Egmond-Kreileman H, Moshaver B, van der Leur SJCM, Stegeman CA et al. Accurate and fast urinalysis in febrile patients by flow cytometry. Infectious Diseases. 2017 May 4;49(5):380-387. https://doi.org/10.1080/23744235.2016.1274048