Performance Of The Sysmex UF-1000i Urine Analyser In The Rapid Diagnosis Of Urinary Tract Infections In Hospitalized Patients

Urinary tract infections (UTIs) are the second most frequently encountered nosocomial infectious diseases, and Which greatly increase the cost of medical care and prolong the duration of hospital stays.Objective:We aimed to evaluate the performance of the Sysmex UF-1000i Analyser for the rapid prediction of UTIs in hospitalized patients with or without indwelling catheters at a comprehensive teaching hospital that encounters complex disease types.Methods:Urine specimens (n=1016) were cultured and examined for white blood cell (WBC),red blood cell (RBC), bacteria (BACT) and yeast-like cells (YLCs) count using the Sysmex UF-1000i. The results of the UF-1000i analysis were compared with the urine culture results. Receiver operating characteristic (ROC) curve analysis was applied to determine BACT and YLCs cutoff values for bacterial and fungal UTIs independently. The diagnostic ability of the UF-1000i was also compared for patients with and without indwelling catheters and patients taking antibiotic or not before sample collection.Results:A cutoff value of 38.7×106/L was acceptable for ruling out bacterial UTIs. In this setting, we achieved a sensitivity of 90.5%, a specificity of 67.4%, a negative predictive value of 94.5%, a false negative rate of 2.85%(29 cases), and avoided culturing in 51.7% of the samples. At a cutoff value of 15.2 ×106/L, we obtained a sensitivity of 72.7% and a specificity of 90.3% for diagnosing fungal UTIs. The BACT count presented a larger area under the curve for patients with indwelling catheters than for those without (0.939 vs.0.861); however, no significant difference in the diagnostic ability of the two curves was found. Analysis of BACT diagnosing ablity of UTIs in patients with or without antibiotic treatment also showed no statistic difference between the two under curve area (0.913vs.0.892).Conclusion:The Sysmex UF-1000i Analyser could be a reliable method for excluding bacterial UTIs in hospitalized patients with or without urinary catheters and could help clinicians determine whether antibiotic therapy is necessary.