Emerging and Fastidious Uropathogens Were Detected by M-PCR with Similar Prevalence and Cell Density in Catheter and Midstream Voided Urine Indicating the Importance of These Microbes in Causing UTIs
Dakun Wang,1 Emery Haley,2 Natalie Luke,2 Mohit Mathur,3 Richard A Festa,3 Xinhua Zhao,4 Lori A Anderson,5 Jennifer L Allison,6 Kristen L Stebbins,6 Manuel Jose Diaz,6 David Baunoch7 1Department of Writing, Stat4Ward, Pittsburgh, PA, USA; 2Department of Clinical Research, Pathnostics, Irvine, CA, US...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2023-12-01
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| Series: | Infection and Drug Resistance |
| Subjects: | |
| Online Access: | https://www.dovepress.com/emerging-and-fastidious-uropathogens-were-detected-by-m-pcr-with-simil-peer-reviewed-fulltext-article-IDR |
| _version_ | 1827398024980070400 |
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| author | Wang D Haley E Luke N Mathur M Festa RA Zhao X Anderson LA Allison JL Stebbins KL Diaz MJ Baunoch D |
| author_facet | Wang D Haley E Luke N Mathur M Festa RA Zhao X Anderson LA Allison JL Stebbins KL Diaz MJ Baunoch D |
| author_sort | Wang D |
| collection | DOAJ |
| description | Dakun Wang,1 Emery Haley,2 Natalie Luke,2 Mohit Mathur,3 Richard A Festa,3 Xinhua Zhao,4 Lori A Anderson,5 Jennifer L Allison,6 Kristen L Stebbins,6 Manuel Jose Diaz,6 David Baunoch7 1Department of Writing, Stat4Ward, Pittsburgh, PA, USA; 2Department of Clinical Research, Pathnostics, Irvine, CA, USA; 3Department of Medical Affairs, Pathnostics, Irvine, CA, USA; 4Department of Statistical Analysis, Stat4Ward, Pittsburgh, PA, USA; 5L. Anderson Diagnostic Market Access Consulting, San Diego, CA, USA; 6DispatchHealth, Denver, CO, USA; 7Pathnostics, Irvine, CA, 92618, USACorrespondence: David Baunoch, Pathnostics, 15545 Sand Canyon Suite 100, Irvine, CA, 92618, USA, Tel +1 714-966-1221, Fax +1 714-966-1231, Email dbaunoch@pathnostics.comIntroduction: This study compared microbial compositions of midstream and catheter urine specimens from patients with suspected complicated urinary tract infections to determine if emerging and fastidious uropathogens are infecting the bladder or are contaminants.Methods: Urine was collected by in-and-out catheter (n = 1000) or midstream voiding (n = 1000) from 2000 adult patients (≥ 60 years of age) at 17 DispatchHealth sites across 11 states. The two groups were matched by age (mean 81 years), sex (62.1% female, 37.9% male), and ICD-10-CM codes. Microbial detection was performed with multiplex polymerase chain reaction (M-PCR) with a threshold for “positive detection” ≥ 10,000 cells/mL for bacteria or any detection for yeast. Results were divided by sex.Results: In females, 28 of 30 microorganisms/groups were found by both collection methods, while in males 26 of 30 were found by both. There were significant overlaps in the detection and densities of classical uropathogens including Escherichia coli, Enterococcus faecalis, and Klebsiella pneumoniae, as well as emerging uropathogens including Actinotignum schaalii and Aerococcus urinae. In females, detection rates were slightly higher in midstream voided compared to catheter-collected (p = 0.0005) urine samples, while males showed the opposite trend (p < 0.0001). More polymicrobial infections were detected in midstream voided compared to catheter-collected samples (64.4% vs 45.7%, p < 0.0001) in females but the opposite in males (35.6% vs 47.0%, p = 0.002).Discussion: In-and-out catheter-collected and midstream voided urine specimens shared significant similarities in microbial detections by M-PCR, with some differences found for a small subset of organisms and between sexes.Conclusion: Non-invasive midstream voided collection of urine specimens for microbial detection and identification in cases of presumed UTI does not result in significantly more contamination compared to in-and-out catheter-collected specimens. Additionally, organisms long regarded as contaminants should be reconsidered as potential uropathogens.Keywords: urinary tract infection, standard urine culture, diagnostic testing, multiplex polymerase chain reaction, catheter, midstream voided |
| first_indexed | 2024-03-08T19:22:29Z |
| format | Article |
| id | doaj.art-75594e45a20a408e9eadf918fa4f612c |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-03-08T19:22:29Z |
| publishDate | 2023-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-75594e45a20a408e9eadf918fa4f612c2023-12-26T18:05:30ZengDove Medical PressInfection and Drug Resistance1178-69732023-12-01Volume 167775779589257Emerging and Fastidious Uropathogens Were Detected by M-PCR with Similar Prevalence and Cell Density in Catheter and Midstream Voided Urine Indicating the Importance of These Microbes in Causing UTIsWang DHaley ELuke NMathur MFesta RAZhao XAnderson LAAllison JLStebbins KLDiaz MJBaunoch DDakun Wang,1 Emery Haley,2 Natalie Luke,2 Mohit Mathur,3 Richard A Festa,3 Xinhua Zhao,4 Lori A Anderson,5 Jennifer L Allison,6 Kristen L Stebbins,6 Manuel Jose Diaz,6 David Baunoch7 1Department of Writing, Stat4Ward, Pittsburgh, PA, USA; 2Department of Clinical Research, Pathnostics, Irvine, CA, USA; 3Department of Medical Affairs, Pathnostics, Irvine, CA, USA; 4Department of Statistical Analysis, Stat4Ward, Pittsburgh, PA, USA; 5L. Anderson Diagnostic Market Access Consulting, San Diego, CA, USA; 6DispatchHealth, Denver, CO, USA; 7Pathnostics, Irvine, CA, 92618, USACorrespondence: David Baunoch, Pathnostics, 15545 Sand Canyon Suite 100, Irvine, CA, 92618, USA, Tel +1 714-966-1221, Fax +1 714-966-1231, Email dbaunoch@pathnostics.comIntroduction: This study compared microbial compositions of midstream and catheter urine specimens from patients with suspected complicated urinary tract infections to determine if emerging and fastidious uropathogens are infecting the bladder or are contaminants.Methods: Urine was collected by in-and-out catheter (n = 1000) or midstream voiding (n = 1000) from 2000 adult patients (≥ 60 years of age) at 17 DispatchHealth sites across 11 states. The two groups were matched by age (mean 81 years), sex (62.1% female, 37.9% male), and ICD-10-CM codes. Microbial detection was performed with multiplex polymerase chain reaction (M-PCR) with a threshold for “positive detection” ≥ 10,000 cells/mL for bacteria or any detection for yeast. Results were divided by sex.Results: In females, 28 of 30 microorganisms/groups were found by both collection methods, while in males 26 of 30 were found by both. There were significant overlaps in the detection and densities of classical uropathogens including Escherichia coli, Enterococcus faecalis, and Klebsiella pneumoniae, as well as emerging uropathogens including Actinotignum schaalii and Aerococcus urinae. In females, detection rates were slightly higher in midstream voided compared to catheter-collected (p = 0.0005) urine samples, while males showed the opposite trend (p < 0.0001). More polymicrobial infections were detected in midstream voided compared to catheter-collected samples (64.4% vs 45.7%, p < 0.0001) in females but the opposite in males (35.6% vs 47.0%, p = 0.002).Discussion: In-and-out catheter-collected and midstream voided urine specimens shared significant similarities in microbial detections by M-PCR, with some differences found for a small subset of organisms and between sexes.Conclusion: Non-invasive midstream voided collection of urine specimens for microbial detection and identification in cases of presumed UTI does not result in significantly more contamination compared to in-and-out catheter-collected specimens. Additionally, organisms long regarded as contaminants should be reconsidered as potential uropathogens.Keywords: urinary tract infection, standard urine culture, diagnostic testing, multiplex polymerase chain reaction, catheter, midstream voidedhttps://www.dovepress.com/emerging-and-fastidious-uropathogens-were-detected-by-m-pcr-with-simil-peer-reviewed-fulltext-article-IDRurinary tract infectionstandard urine culturediagnostic testingmultiplex polymerase chain reactioncathetermidstream voided |
| spellingShingle | Wang D Haley E Luke N Mathur M Festa RA Zhao X Anderson LA Allison JL Stebbins KL Diaz MJ Baunoch D Emerging and Fastidious Uropathogens Were Detected by M-PCR with Similar Prevalence and Cell Density in Catheter and Midstream Voided Urine Indicating the Importance of These Microbes in Causing UTIs Infection and Drug Resistance urinary tract infection standard urine culture diagnostic testing multiplex polymerase chain reaction catheter midstream voided |
| title | Emerging and Fastidious Uropathogens Were Detected by M-PCR with Similar Prevalence and Cell Density in Catheter and Midstream Voided Urine Indicating the Importance of These Microbes in Causing UTIs |
| title_full | Emerging and Fastidious Uropathogens Were Detected by M-PCR with Similar Prevalence and Cell Density in Catheter and Midstream Voided Urine Indicating the Importance of These Microbes in Causing UTIs |
| title_fullStr | Emerging and Fastidious Uropathogens Were Detected by M-PCR with Similar Prevalence and Cell Density in Catheter and Midstream Voided Urine Indicating the Importance of These Microbes in Causing UTIs |
| title_full_unstemmed | Emerging and Fastidious Uropathogens Were Detected by M-PCR with Similar Prevalence and Cell Density in Catheter and Midstream Voided Urine Indicating the Importance of These Microbes in Causing UTIs |
| title_short | Emerging and Fastidious Uropathogens Were Detected by M-PCR with Similar Prevalence and Cell Density in Catheter and Midstream Voided Urine Indicating the Importance of These Microbes in Causing UTIs |
| title_sort | emerging and fastidious uropathogens were detected by m pcr with similar prevalence and cell density in catheter and midstream voided urine indicating the importance of these microbes in causing utis |
| topic | urinary tract infection standard urine culture diagnostic testing multiplex polymerase chain reaction catheter midstream voided |
| url | https://www.dovepress.com/emerging-and-fastidious-uropathogens-were-detected-by-m-pcr-with-simil-peer-reviewed-fulltext-article-IDR |
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