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Customized cutoff limits for the sediMAX-2 automated analyzer reduce the number of urine culture tests
BACKGROUND AND AIM: Urinary tract infections are highly prevalent in nosocomial and community settings. Their diagnosis, although costly and time-consuming, is crucial to avoid inappropriate treatments and/or clinical complications. In this context, automated analyzers have been developed and commer...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Mattioli 1885
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644934/ https://www.ncbi.nlm.nih.gov/pubmed/37850763 http://dx.doi.org/10.23750/abm.v94i5.14951 |
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author | Ferrari, Davide Trbos, Mladen Vidali, Matteo Locatelli, Massimo |
author_facet | Ferrari, Davide Trbos, Mladen Vidali, Matteo Locatelli, Massimo |
author_sort | Ferrari, Davide |
collection | PubMed |
description | BACKGROUND AND AIM: Urinary tract infections are highly prevalent in nosocomial and community settings. Their diagnosis, although costly and time-consuming, is crucial to avoid inappropriate treatments and/or clinical complications. In this context, automated analyzers have been developed and commercialized to screen and rule out negative urine samples. Adjustments of the manufacturers’ suggested cutoff values might lead to substantial diagnostic and economic advantages. METHODS: We retrospectively analyzed 776 urine samples from different individuals. 546 samples (training group) were used to optimize and develop new cutoff values. The remaining 230 samples (validation group) were used to validate the optimized cutoffs. All samples were subjected to urine culture, 17% resulted positive. Escherichia coli and Enterococcus faecalis were the two most frequently identified bacteria, 95 and 9 samples, respectively. RESULTS: Two different cutoff levels were obtained. Cutoff-A (bacteria>110 and/or white blood cells> 15 cells/μL), showed the same sensitivity as the manufacturers’ suggested cutoff, yet leads to a large reduction of the samples to be cultured. Cutoff-B (bacteria>50 and/or white blood cells>20 cell/μL), showed an almost 100% sensitivity by subjecting only ~70% of the samples to urine culture. CONCLUSIONS: Cutoff-A is a good compromise between sensitivity and specificity yet allowing economic advantages by reducing the number of urinary cultures. Cutoff-B relegates urinary tract infection misdiagnosis to a rare event without the need of culturing the entire batch of samples. We believe that clinical implementation of the proposed cutoffs will help other laboratories, using similar instrumentation, to reach their most convenient balance between sensitivity and economic needs. (www.actabiomedica.it) |
format | Online Article Text |
id | pubmed-10644934 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Mattioli 1885 |
record_format | MEDLINE/PubMed |
spelling | pubmed-106449342023-11-15 Customized cutoff limits for the sediMAX-2 automated analyzer reduce the number of urine culture tests Ferrari, Davide Trbos, Mladen Vidali, Matteo Locatelli, Massimo Acta Biomed Original Article BACKGROUND AND AIM: Urinary tract infections are highly prevalent in nosocomial and community settings. Their diagnosis, although costly and time-consuming, is crucial to avoid inappropriate treatments and/or clinical complications. In this context, automated analyzers have been developed and commercialized to screen and rule out negative urine samples. Adjustments of the manufacturers’ suggested cutoff values might lead to substantial diagnostic and economic advantages. METHODS: We retrospectively analyzed 776 urine samples from different individuals. 546 samples (training group) were used to optimize and develop new cutoff values. The remaining 230 samples (validation group) were used to validate the optimized cutoffs. All samples were subjected to urine culture, 17% resulted positive. Escherichia coli and Enterococcus faecalis were the two most frequently identified bacteria, 95 and 9 samples, respectively. RESULTS: Two different cutoff levels were obtained. Cutoff-A (bacteria>110 and/or white blood cells> 15 cells/μL), showed the same sensitivity as the manufacturers’ suggested cutoff, yet leads to a large reduction of the samples to be cultured. Cutoff-B (bacteria>50 and/or white blood cells>20 cell/μL), showed an almost 100% sensitivity by subjecting only ~70% of the samples to urine culture. CONCLUSIONS: Cutoff-A is a good compromise between sensitivity and specificity yet allowing economic advantages by reducing the number of urinary cultures. Cutoff-B relegates urinary tract infection misdiagnosis to a rare event without the need of culturing the entire batch of samples. We believe that clinical implementation of the proposed cutoffs will help other laboratories, using similar instrumentation, to reach their most convenient balance between sensitivity and economic needs. (www.actabiomedica.it) Mattioli 1885 2023 2023-10-17 /pmc/articles/PMC10644934/ /pubmed/37850763 http://dx.doi.org/10.23750/abm.v94i5.14951 Text en Copyright: © 2023 ACTA BIO MEDICA SOCIETY OF MEDICINE AND NATURAL SCIENCES OF PARMA https://creativecommons.org/licenses/by-nc-sa/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License |
spellingShingle | Original Article Ferrari, Davide Trbos, Mladen Vidali, Matteo Locatelli, Massimo Customized cutoff limits for the sediMAX-2 automated analyzer reduce the number of urine culture tests |
title | Customized cutoff limits for the sediMAX-2 automated analyzer reduce the number of urine culture tests |
title_full | Customized cutoff limits for the sediMAX-2 automated analyzer reduce the number of urine culture tests |
title_fullStr | Customized cutoff limits for the sediMAX-2 automated analyzer reduce the number of urine culture tests |
title_full_unstemmed | Customized cutoff limits for the sediMAX-2 automated analyzer reduce the number of urine culture tests |
title_short | Customized cutoff limits for the sediMAX-2 automated analyzer reduce the number of urine culture tests |
title_sort | customized cutoff limits for the sedimax-2 automated analyzer reduce the number of urine culture tests |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644934/ https://www.ncbi.nlm.nih.gov/pubmed/37850763 http://dx.doi.org/10.23750/abm.v94i5.14951 |
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