Detecting Urinary Tract Infection (UTI)

How Urine Culture Candidates Reports streamline the UTI testing process

Estimated read time: 3 minutes

What Is a UTI?

A urinary tract infection, or UTI, is an infection that involves any part of the urinary system, including the urethra, bladder, ureters and kidneys.¹⁰ Urinary tract infections are the most common type of healthcare-associated infection reported to the CDC’s National Healthcare Safety Network.¹⁰ They lead to more antibiotic prescriptions following doctor visits than any other types of infection.¹UTIs place an economic burden on healthcare organizations. In the U.S., they account for over 100,000 hospitalizations at an annual cost of $1.6 billion.¹⁶

The facts about UTIs

#1 infection that leads to an antibiotic prescription after a physician’s visit¹
Approximately 150 million develop UTIs in a given year²
39-50% of the female lab samples sent for cultures come back negative⁸
UTI overdiagnosis rates in women are 31-57%⁸
About 25% of adult sepsis cases originate from urogenital tract infections, with most of these cases caused by complicated UTIs⁹
Approximately 15% of all community-prescribed antibiotics dispensed in the U.S. are for UTI⁶; some European countries report similar findings⁷
UTIs occur 8x more often in women than men³
In the U.S. 3.6 million emergency department (ED) visits per year are related to UTIs⁵
50-60% of women report having had a UTI at some point in their lives⁴
The economic burden in ED for UTI treatment is estimated at $2 billion annually⁵

Download UTI facts infographic ›

Supporting UTI Diagnosis with Urine Analyzer Results

UTI diagnosis is usually based on two tests, both of which require a urine sample.

Urinalysis, a screening test that provides information about the clarity and contents of urine, which includes the number of white blood cells, bacteria, leukocytes, nitrites and other parameters
Urine culture analysis, a test that helps to detect and identify bacteria in the sample, which can guide antibiotic treatment

How accurate lab UTI testing supports antimicrobial stewardship

Microbiology laboratories need rapid screening methods that can accurately detect bacteria in urine samples and support the administration of treatment. This need is highlighted by reports that about two-thirds of urine samples cultured will not yield any bacteria or will yield growth at levels too insignificant to indicate treatment.^11,12

Antimicrobial stewardship involves the appropriate use of antibiotics. Effective antimicrobial stewardship is closely linked to the ability to diagnose infections, such as UTI. An excessive use of antibiotics is one of the contributing factors to antibiotic resistance, which has become a growing global public health concern.¹³ Saving lives by stopping the spread of antibiotic resistance requires aggressive action, according to the CDC. This includes improving antibiotic use to slow its development.¹⁴

What automated urinalysis analyzers offer for UTI detection

Urine chemistry and microscopy analyzers can assist in laboratory prediction of urinary tract infection symptoms and indicators and help signal samples that need to be cultured.¹⁵ The main purpose of using automated urine analyzers is to reduce the number of samples unnecessarily subjected to urine culture. This helps to decrease test turnaround times and reduce patients’ financial burden.¹⁵

Streamlining the UTI Testing Workflow

Urine Culture Candidates Reports, available on the iQ Workcell automated urinalysis analyzer, is a tool that may offer insight into possible UTI. The reports are designed to streamline the UTI testing workflow by generating work lists of possible urinary tract infection patient sample values requiring review. The values are based on user-defined thresholds and indicate samples for possible release or reflex to microbiology for urine culture analysis.

Urine Culture Candidates Reports display patient sample identification and a summary of combined urine chemistry and microscopy values, consistent with the Urine Culture Indicator Checklist:

Leukocyte esterase
Nitrites
White blood cells (WBCs)
Bacteria
All small particles (ASPs)

For applicable urinalysis microscopy instrumentation without direct connection to a urine chemistry analyzer, generated Urine Culture Candidates Reports include a summary of the following relevant microscopy values:

WBCs
Bacteria
ASPs

Laboratory technologists can review the reports on the screen or print them out for future reference.

Webinar Maximizing Productivity in Urinary Tract Infection Testing

Find out how Urine Culture Candidates Reports help support laboratory workflow and UTI detection in this on-demand webinar.

Learn more

Scalable, Harmonized and Designed for Your Lab’s Needs

Experience the accuracy, reliability and clinical insights of the iQ series of urinalysis workcells. These fully automated systems pair two of the world's most highly regarded automated urine analyzers to help laboratories deliver standardized urinalysis results, improve workflow and ensure less unplanned downtime.

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¹Lee, Helen and Le, Jennifer. Urinary Tract Infections. PSAP 2018 BOOK 1: Infectious Diseases.
²Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. “Urinary tract infections: epidemiology, mechanisms of infection and treatment options.” Nat Rev Microbiol, 2015, vol. 13, no. 5, pp. 269–284.
³Al-Badr A, and Al-Shaikh G. “Recurrent Urinary Tract Infections Management in Women.” SQU Med J, 2013, vol. 13, no. 3, pp. 359–367. doi: 10.12816/0003256.
⁴Rahn DD. “Urinary Tract Infections: Contemporary Management.” Urol Nurs, 2008, vol. 28, no. 5, pp. 333–342.
⁵Abbo LM, Hooton TM. “Antimicrobial Stewardship and Urinary Tract Infections.” Antibiotics, 2014, vol. 3, no. 2, pp. 174 –192.
⁶Mazzulli T. “Resistance Trends in Urinary Tract Pathogens and Impact on Management.” J Urol, 2002, vol. 168, no. 4, pt. 2, pp. 1720–22.
⁷Aabenhus, R., Hansen, M. P., Siersma, V., & Bjerrum, L. (2017). Clinical indications for antibiotic use in Danish general practice: results from a nationwide electronic prescription database. Scandinavian Journal of Primary Health Care, 35(2), 162–169. https://doi.org/10.1080/02813432.2017.1333321.
⁸Tomas ME, Getman D, Donskey CJ, Hecker MT. 2015. Overdiagnosis of urinary tract infection and underdiagnosis of sexually transmitted infection in adult women presenting to an emergency department. J Clin Microbiol 53:2686 –2692. doi:10.1128/JCM.00670-15.
⁹Wagenlehner FME, Lichtenstern C, Rolfes C et al. “Diagnosis and Management for Urosepsis.” Int J Urol.
¹⁰The Centers for Disease Control. “Urinary Tract Infection (Catheter-Associated Urinary Tract Infection [CAUTI] and Non-Catheter-Associated Urinary Tract Infection [UTI]) and Other Urinary System Infection [USI]) Events.” www.cdc.gov/nhsn/pdfs/pscmanual/7psccauticurrent.pdf, January 2019. Accessed 15 Oct. 2019.
¹¹Stürenburg E, Kramer J, Schön G et. al. “Detection of Significant Bacteriuria by Use of the iQ200 Automated Urine Microscope.” JCM, 2014, vol. 52. pp. 2855–2860.
¹²Fok C, Fitzgerald MP, Turk T et al. “Reflex Testing of Male Urine Specimens Misses Few Positive Cultures May Reduce Unnecessary Testing of Normal Specimens.” Urol, 2010, vol. 75, no. 1, pp. 74–76. doi.org/10.1016/j.urology.2009.08.071.
¹³Aslam B, Wang W, Arshad MI et al. “Antibiotic Resistance: A Rundown of a Global Crisis.” Infect Drug Resist, 2018, vol. 11, pp. 1645–1658. doi: 10.2147/IDR.S173867.
¹⁴CDC. Antibiotic Resistance Threats in the United States, 2019. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2019.
¹⁵Beckman Coulter. Instructions for Use - iQ200 Series. October 2017.
¹⁶Simmering JE, Tang F, Cavanaugh JE et al. “The Increase in Hospitalizations for Urinary Tract Infections and the Associated Costs in the United States, 1998–2011.” Open Forum Infect Dis, 2017, vol. 4, no. 1, p. ofw281. doi: 10.1093/ofid/ofw281.

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