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Infectious Diseases (London, England) May 2021Urinary tract infection (UTI) diagnosis in infants is often made by a positive urine culture result, regardless of urine dipstick findings.
BACKGROUND
Urinary tract infection (UTI) diagnosis in infants is often made by a positive urine culture result, regardless of urine dipstick findings.
AIM
To assess parameters that may affect positive urine culture results interpretation in infants, including dipstick performance, obtainment method, bacteria type, age and laboratory results.
METHODS
A retrospective, cohort study. Infants <90 days with urine dipstick and culture obtained through subrapubic aspiration (SPA) or catheter, 2015-2016, were included.
RESULTS
Overall, 19% (129/678) of cultures were positive. The dipstick sensitivity was 51% for all cultures; 66%, 47%, 15% and 10% for (= 71), (= 19), (= 34) and (= 10), respectively (<.001). Sensitivity was higher in SPA vs. catheter for all cultures (67% vs. 43%); (78% vs. 59%); and (88% vs. 18%). For , dipstick sensitivity was low in both SPA and catheter (0-16%). All episodes were catheter obtained. Positive culture with negative dipstick and episodes had lower C-reactive protein levels, and higher proportion of mixed infection compared with positive dipstick and episodes.
CONCLUSIONS
Urine cultures in infants should be obtained by SPA, since catheter-obtained, and positive cultures may represent contamination or asymptomatic bacteriuria, rather than true UTI.
Topics: Bacteriuria; Catheters; Cohort Studies; Enterococcus; Escherichia coli; Humans; Infant; Proteus; Retrospective Studies; Urinalysis; Urinary Tract Infections; Urine
PubMed: 33620253
DOI: 10.1080/23744235.2021.1885731 -
BMC Cardiovascular Disorders Nov 2021Atherosclerosis is a vital cause of cardiovascular diseases. The correlation between proteinuria and atherosclerosis, however, has not been confirmed. This study aimed... (Observational Study)
Observational Study
BACKGROUND AND AIMS
Atherosclerosis is a vital cause of cardiovascular diseases. The correlation between proteinuria and atherosclerosis, however, has not been confirmed. This study aimed to assess whether there is a relationship between proteinuria and atherosclerosis.
METHODS
From January 2016 to September 2020, 13,545 asymptomatic subjects from four centres in southern China underwent dipstick proteinuria testing and carotid atherosclerosis examination. Data on demography and past medical history were collected, and laboratory examinations were performed. The samples consisted of 7405 subjects (4875 males and 2530 females), excluding subjects failing to reach predefined standards and containing enough information. A multivariate logistic regression model was used to adjust the influence of traditional risk factors for atherosclerosis on the results.
RESULTS
Compared with proteinuria-negative subjects, proteinuria-positive subjects had a higher prevalence rate of carotid atherosclerosis. The differences were statistically significant (22.6% vs. 26.7%, χ = 10.03, p = 0.002). After adjusting for common risk factors for atherosclerosis, age, sex, BMI, blood lipids, blood pressure, renal function, hypertensive disease, diabetes mellitus and hyperlipidaemia, proteinuria was an independent risk factor for atherosclerosis (OR = 1.191, 95% CI 1.015-1.398, p = 0.033). The Hosmer-Lemeshow test was used to test the risk prediction model of atherosclerosis, and the results showed that the model has high goodness of fit and strong independent variable prediction ability.
CONCLUSIONS
Proteinuria is independently related to carotid atherosclerosis. With the increase in proteinuria level, the risk of carotid atherosclerotic plaque increases. For patients with positive proteinuria, further examination of atherosclerosis should not be ignored.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Carotid Artery Diseases; China; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Predictive Value of Tests; Prognosis; Proteinuria; Reagent Strips; Risk Assessment; Risk Factors; Ultrasonography, Doppler, Color; Urinalysis; Young Adult
PubMed: 34798829
DOI: 10.1186/s12872-021-02367-x -
Journal of Epidemiology Jan 2021Previous studies have suggested the potential association between renal diseases and gallstone. The extent of proteinuria is recognized as a marker for the severity of...
BACKGROUND
Previous studies have suggested the potential association between renal diseases and gallstone. The extent of proteinuria is recognized as a marker for the severity of chronic kidney disease. However, little data is available to identify the risk of incident gallstone according to the level of proteinuria.
METHODS
Using a data of 207,356 Koreans registered in National Health Insurance Database, we evaluated the risk of gallstone according to the levels of urine dipstick proteinuria through an average follow-up of 4.36 years. Study subjects were divided into 3 groups by urine dipstick proteinuria (negative: 0, mild: 1+ and heavy: 2+ or greater). Multivariate Cox-proportional hazard model was used to assess the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident cholelithiasis according to urine dipstick proteinuria.
RESULTS
The group with higher urine dipstick proteinuria had worse metabolic, renal, and hepatic profiles than those without proteinuria, which were similarly observed in the group with incident cholelithiasis. The heavy proteinuria group had the greatest incidence of cholelithiasis (2.39%), followed by mild (1.54%) and negative proteinuria groups (1.39%). Analysis for multivariate Cox-proportional hazard model indicated that the heavy proteinuria group had higher risk of cholelithiasis than other groups (negative: reference, mild proteinuria: HR 0.97 [95% CI, 0.74-1.26], and heavy proteinuria: HR 1.46 [95% CI, 1.09-1.96]).
CONCLUSION
Urine dipstick proteinuria of 2+ or greater was significantly associated with increased risk for incident gallstone.
Topics: Adult; Biomarkers; Cholelithiasis; Databases, Factual; Female; Gallstones; Glomerular Filtration Rate; Humans; Incidence; Male; Middle Aged; Predictive Value of Tests; Proteinuria; Republic of Korea; Risk Factors; Urinalysis
PubMed: 31956168
DOI: 10.2188/jea.JE20190223 -
Biosensors Apr 2020Point-of-care (POC) diagnostics enables the diagnosis and monitoring of patients from the clinic or their home. Ideally, POC devices should be compact, portable and...
Point-of-care (POC) diagnostics enables the diagnosis and monitoring of patients from the clinic or their home. Ideally, POC devices should be compact, portable and operatable without the requirement of expertise or complex fluid mechanical controls. This paper showcases a chip-and-dip device, which works on the principle of capillary-driven flow microfluidics and allows analytes' detection by multiple microchannels in a single microchip via smartphone imaging. The chip-and-dip device, fabricated with inexpensive materials, works by simply dipping the reagents-coated microchip consisting of microchannels into a fluidic sample. The sample is loaded into the microchannels via capillary action and reacts with the reagents to produce a colourimetric signal. Unlike dipstick tests, this device allows the loading of bacterial/pathogenic samples for antimicrobial testing. A single device can be coated with multiple reagents, and more analytes can be detected in one sample. This platform could be used for a wide variety of assays. Here, we show the design, fabrication and working principle of the chip-and-dip flow device along with a specific application consisting in the determination of β-lactamase activity and cortisol. The simplicity, robustness and multiplexing capability of the chip-and-dip device will allow it to be used for POC diagnostics.
Topics: Colorimetry; Equipment Design; Humans; Lab-On-A-Chip Devices; Microfluidics; Point-of-Care Testing; Smartphone
PubMed: 32326641
DOI: 10.3390/bios10040039 -
Archivos Espanoles de Urologia Jul 2020Urinary pH is a decisive factor in several pathologies, there by an informative marker employed in treatment decisions. Although extensively used, the urinary pH...
OBJECTIVES
Urinary pH is a decisive factor in several pathologies, there by an informative marker employed in treatment decisions. Although extensively used, the urinary pH dipstick test may not be sufficiently accurate or precise for clinical decisions and more robust methodologies need to be considered. In this study, we compare pH measurements when using aportable medical device and different dipstick tests.
MATERIALS AND METHODS
Four pH dipstick brands and a Lit-Control® pH Meter were tested using commercial buffer solutions with seven distinct pH values representing the physiological range in urine (4.66; 5.0;5.5; 6.0; 7.0; 7.5; 8.0). A statistical analysis was performed to assess the correlation of measured versus real values, together with validity measures as resolution,precision and accuracy.
RESULTS
Validity measures stated the superiority of the portable pH meter, with a reduced dispersion of data and more exact values. Additionally, correlation analysis demonstrate that the pH values obtained with the pH meter were the closest to the buffers' real pH values.
CONCLUSION
The detailed comparative study presented here reveal the superiority of a portable pH meter to several of the most used dipstick brands in the clinic.Lit-Control® pH Meter represents a reliable alternative when a monitoring of urinary pH is needed, as may happen during the screening of diseases or treatment monitoringin the clinic, as well as during the self-monitoringby the patient under professional supervision at home.
Topics: Employment; Humans; Hydrogen-Ion Concentration; Reagent Strips; Urinalysis
PubMed: 32633250
DOI: No ID Found -
BMC Pediatrics Aug 2020There is a need for an easy and sensitive method for screening of urinary tract infections in young children. We set out to test whether a novel diaper-embedded urine...
BACKGROUND
There is a need for an easy and sensitive method for screening of urinary tract infections in young children. We set out to test whether a novel diaper-embedded urine test device is feasible and reliable in screening for urinary tract infections.
METHODS
This prospective cohort study consisted of young children examined due to a suspected acute urinary tract infection at the Pediatric Emergency Department of the Oulu University Hospital, Finland. We analyzed the same urine samples using three different methods: 1) a diaper-embedded test device applied to the urine pad within the diaper, 2) a urine sample aspirated from the urine pad for the conventional point-of-care dipstick test, and 3) a urine sample aspirated from the urine pad and analyzed in the laboratory with an automated urine chemistry analyzer. The gold standard for confirming urinary tract infection was quantitative bacterial culture.
RESULTS
Urine samples were available from 565 children. Bacterial culture confirmed urinary tract infection in 143 children. Sensitivity of the positive leukocyte screening of the diaper-embedded urine test device was 93.1% (95% CI: 87.4-96.8) and that of the point-of-care urine dipstick analysis was 95.4% (90.3-98.3) in those with both tests results available (n = 528). The sensitivity of the positive leukocyte test of the diaper-embedded test device was 91.4% (85.4-95.5) and that of the automated analysis was 88.5% (82.0-93.3) in those with both tests available (n = 547). The time to the test result after urination was immediate for the diaper-embedded test, 1-5 min for point-of-care dipstick, and 30-60 min for laboratory-based automated urine chemistry analyzer.
CONCLUSIONS
In this prospective study, the diaper-embedded urine test device was an easy and sensitive screening method for UTIs in young children. The main clinical benefit of the diaper-embedded urine test device was that the screening test result was available immediately after urination.
Topics: Child; Child, Preschool; Cohort Studies; Finland; Humans; Prospective Studies; Sensitivity and Specificity; Urinalysis; Urinary Tract Infections
PubMed: 32781982
DOI: 10.1186/s12887-020-02277-5 -
Drug Testing and Analysis Sep 2019Dihydroartemisinin (DHA) and piperaquine (PPQ) are two drugs used in an artemisinin-based combination therapy (ACT). The circulation of counterfeit antimalarial drugs...
Dihydroartemisinin (DHA) and piperaquine (PPQ) are two drugs used in an artemisinin-based combination therapy (ACT). The circulation of counterfeit antimalarial drugs demands the development of simple, point-of-care (POC) tests for monitoring drug quality. Here we aimed to design an antibody-based lateral flow dipstick assay for simultaneous quality control of DHA and PPQ. To obtain a monoclonal antibody (mAb) for PPQ, one structural unit of the symmetric PPQ molecule was used to derive a carboxylic acid for linkage to a carrier protein as immunogen. Screening of hybridoma cells identified an mAb 4D112B2 that reacted with the PPQ-based immunogen. A highly-sensitive icELISA was designed based on this mAb, which showed 50% inhibition concentration of PPQ at 1.66 ng/mL and a working range of 0.35 - 7.40 ng/mL. The mAb showed 10.2, 15.9 and 30.4% cross reactivity to hydroxychloroquine sulfate, chloroquine and amodiaquine, respectively. No cross reactivity was observed to lumefantrine, mefloquine artemisinin and its derivatives. Using our previous DHA dipstick design, a lateral flow dipstick for simultaneous analysis of PPQ and DHA was developed. The indicator ranges for PPQ and DHA were 2 - 5 μg/mL and 250 - 500 ng/mL, respectively. The dipstick was used to semi-quantitatively analyze PPQ and DHA content in commercial ACT drugs, which produced agreeable results to those determined by high-performance liquid chromatography. This combination dipstick makes it a potential POC device for quality control of the two active ingredients in a commonly used ACT.
Topics: Animals; Antibodies, Monoclonal; Antimalarials; Artemisinins; Drug Combinations; Drug Monitoring; Enzyme-Linked Immunosorbent Assay; Equipment Design; Mice; Point-of-Care Systems; Quinolines; Reagent Strips
PubMed: 31150570
DOI: 10.1002/dta.2656 -
Nature Protocols Nov 2020The complexity of current nucleic acid isolation methods limits their use outside of the modern laboratory environment. Here, we describe a fast and affordable method to...
The complexity of current nucleic acid isolation methods limits their use outside of the modern laboratory environment. Here, we describe a fast and affordable method to purify nucleic acids from animal, plant, viral and microbial samples using a cellulose-based dipstick. Nucleic acids can be purified by dipping in-house-made dipsticks into just three solutions: the extract (to bind the nucleic acids), a wash buffer (to remove impurities) and the amplification reaction (to elute the nucleic acids). The speed and simplicity of this method make it ideally suited for molecular applications, both within and outside the laboratory, including limited-resource settings such as remote field sites and teaching institutions. Detailed instructions for how to easily manufacture large numbers of dipsticks in house are provided. Using the instructions, readers can create more than 200 dipsticks in <30 min and perform dipstick-based nucleic acid purifications in 30 s.
Topics: Animals; Bacteria; Cellulose; Humans; Nucleic Acid Amplification Techniques; Nucleic Acids; Plants; Time Factors; Viruses
PubMed: 33005038
DOI: 10.1038/s41596-020-0392-7 -
Journal of the American Medical... Jun 2021There is unmet need for an easy, noninvasive urine collection method to diagnose urinary tract infections (UTIs) in nursing home residents suffering from urinary...
OBJECTIVE
There is unmet need for an easy, noninvasive urine collection method to diagnose urinary tract infections (UTIs) in nursing home residents suffering from urinary incontinence or cognitive impairments. UTIs are highly prevalent in nursing home residents, and urine specimen collection can be difficult. The objective of this study was to assess if urine specimens collected from super-absorbing incontinence pads (adult diapers) are a reliable collection method for UTI diagnosis.
DESIGN
This was a paired noninferiority laboratory study, in which pairing refers to UTI diagnostics performed directly using clinical urine specimens (reference specimen) and indirectly using urine extracted from diapers (diaper specimen).
SETTING AND PARTICIPANTS
In this study, remnants of 250 clinical urine specimens were used to assess noninferiority in diagnosing UTIs, based on a 1-sided type I error of 2.5%, a power of 90%, and a noninferiority margin of 15%.
METHODS
Urine specimens were poured on super-absorbing disposable adult diapers and extracted after 3 hours, to use for dipstick urinalysis and bacterial culture. UTIs were defined as presence of leukocytes and a positive bacterial culture. Noninferiority was assessed by calculating a Wald-type test statistic.
RESULTS
Noninferiority was established for diagnosing UTIs in diaper specimens, and for each of its components (dipstick leukocyte detection and bacterial culture positivity). Positive bacterial cultures were found in 72 (29.0%) diaper specimens compared with 65 (26.2%) reference specimens (difference -2.8%, 97.5% CI -7.1% to 1.5%). Leukocytes were present in 162 (64.8%) diaper specimens, compared with 175 (70.0%) reference specimens (difference -5.7%, 97.5% CI: -10.6% to -0.7%).
CONCLUSION AND IMPLICATIONS
Our results on diagnosing UTIs, by dipstick analysis and bacterial cultures, using super-absorbing adult diapers are promising. Before translation into clinical practice, further studies are needed to evaluate the risk of bacterial contamination by wearing adult diapers, possibly resulting in overdiagnosis of UTI.
Topics: Adult; Humans; Incontinence Pads; Nursing Homes; Urinalysis; Urinary Incontinence; Urinary Tract Infections
PubMed: 33303395
DOI: 10.1016/j.jamda.2020.10.003 -
Nutrition, Metabolism, and... Oct 2021Prior studies have shown an association between positive urinary protein and an elevated risk of long-term mortality in patients with acute ischemic stroke (AIS);...
BACKGROUND AND AIMS
Prior studies have shown an association between positive urinary protein and an elevated risk of long-term mortality in patients with acute ischemic stroke (AIS); however, data on the short-term prognostic significance of urinary protein and urinary ketone bodies in patients with AIS is sparse.
METHODS AND RESULTS
A total of 2842 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included. Patients were divided into urinary protein positive and negative, urinary ketone bodies positive and negative by urine dipstick. Cox and logistic regression models were used to estimate the effect of urinary protein and urinary ketone bodies on all cause in-hospital mortality and poor outcome upon discharge (modified Rankin Scale score ≥3) in AIS patients. Patients with positive urinary protein was associated with a 2.74-fold and 1.62-fold increase in the risk of in-hospital mortality (adjusted HR 2.74; 95% CI, 1.54-4.89; P-value = 0.001) and poor outcome upon discharge (aOR, 1.62; 95% CI 1.26-2.08; P-value <0.001) in comparison to negative urinary protein after adjusting for potential covariates. Moreover, Patients with positive urinary ketone bodies was associated with 2.11-fold in the risk of poor outcome upon discharge (aOR 2.11; 95% CI 1.52-2.94; P-value <0.001) but not in-hospital mortality (P-value = 0.066) after adjusting for potential covariates.
CONCLUSIONS
Urinary protein at admission was independently associated with in-hospital mortality and poor functional outcome at hospital discharge in acute stroke patients and urinary ketone bodies also associated with poor functional outcome at hospital discharge.
Topics: Aged; Aged, 80 and over; Biomarkers; China; Disability Evaluation; Female; Hospital Mortality; Humans; Inpatients; Ischemic Attack, Transient; Ischemic Stroke; Ketone Bodies; Male; Middle Aged; Patient Admission; Patient Discharge; Predictive Value of Tests; Prognosis; Proteinuria; Reagent Kits, Diagnostic; Risk Assessment; Risk Factors; Urinalysis
PubMed: 34518087
DOI: 10.1016/j.numecd.2021.07.010