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Scientific Reports Nov 2020The objective of this study was to assess the diagnosis value of urinary inflammatory index (UII) and systemic immune-inflammation index (SII) for UTI. Nine inflammatory...
The objective of this study was to assess the diagnosis value of urinary inflammatory index (UII) and systemic immune-inflammation index (SII) for UTI. Nine inflammatory indexes including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, SII and six UIIs were calculated for Receiver operating characteristic curve analysis to select which one is suitable for the screening of UTIs or distinguishing the types of bacteria. UII3, which calculated from leucocyte esterase (LE), nitrite, white blood cells and bacteria, was preferentially used as an indicator for the diagnosis of UTI when the threshold was set at 0.53. UII2 was more suitable for the distinction between groups when the cutoff is set to 0.94. Appropriate urinary inflammation index calculated by rapid urinalysis of urine dipstick and urine sediment can help us to predict urinary tract infection and bacterial type, and reduce the workload and costs of urine culture.
Topics: Aged; Bacteriuria; Blood Platelets; Carboxylic Ester Hydrolases; Female; Humans; Inflammation; Leukocyte Elastase; Leukocytes; Lymphocytes; Male; Mass Screening; Middle Aged; Neutrophils; Nitrites; ROC Curve; Reagent Kits, Diagnostic; Reproducibility of Results; Sensitivity and Specificity; Urinalysis; Urinary Tract Infections
PubMed: 33168850
DOI: 10.1038/s41598-020-76352-3 -
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 -
European Journal of Clinical... Mar 2021Sensitivity and specificity of rapid antigen detection tests (RADTs) for detection of group A hemolytic streptococcus (GAS) vary. The purpose is to present the first...
Performance and user-friendliness of the rapid antigen detection tests QuickVue Dipstick Strep A test and DIAQUICK Strep A Blue Dipstick for pharyngotonsillitis caused by Streptococcus pyogenes in primary health care.
Sensitivity and specificity of rapid antigen detection tests (RADTs) for detection of group A hemolytic streptococcus (GAS) vary. The purpose is to present the first SKUP (Scandinavian evaluation of laboratory equipment for point of care testing) evaluations concerning the assessment of the diagnostic performance and user-friendliness of two RADTs for detection of GAS when used under real-life conditions in primary health care. Throat samples were collected in duplicates at primary health care centers (PHCCs) from patients with symptoms of pharyngitis. The performance of QuickVue Dipstick Strep A test (307 samples) and DIAQUICK Strep A Blue Dipstick (348 samples) was evaluated using culture results at a clinical microbiology laboratory as comparison. The user-friendliness was evaluated using a questionnaire. The diagnostic sensitivity was 92% (90% confidence interval (CI) 87-96%) and 72% (90% CI 65-79%), while the diagnostic specificity was 86% (90% CI 81-90%) and 98% (90% CI 96-99%) for QuickVue Dipstick Strep A test and DIAQUICK Strep A Blue Dipstick, respectively. Both RADTs obtained acceptable assessments for user-friendliness and fulfilled SKUP's quality goal for user-friendliness. The diagnostic sensitivity for QuickVue Dipstick Strep A test and the diagnostic specificity for DIAQUICK Strep A Blue Dipstick in this objective and supplier-independent evaluation were higher compared with previous meta-analyses of RADTs. However, the diagnostic specificity for QuickVue Dipstick Strep A test and the diagnostic sensitivity for DIAQUICK Strep A Blue Dipstick were lower compared with previous meta-analyses of RADTs.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antigens, Bacterial; Child; Child, Preschool; Female; Humans; Infant; Male; Middle Aged; Pharyngitis; Point-of-Care Testing; Primary Health Care; Prospective Studies; Reagent Kits, Diagnostic; Sensitivity and Specificity; Serologic Tests; Streptococcal Infections; Streptococcus pyogenes; Young Adult
PubMed: 32996031
DOI: 10.1007/s10096-020-04034-z -
European Journal of Internal Medicine Jan 2021Urinalysis and urine culture are two of the most commonly ordered tests. A positive urine test in asymptomatic patients often leads to overtreatment. Antimicrobials for...
BACKGROUND
Urinalysis and urine culture are two of the most commonly ordered tests. A positive urine test in asymptomatic patients often leads to overtreatment. Antimicrobials for asymptomatic bacteriuria is one of the most common unnecessary treatments. We aimed to explore the current ordering patterns of urinalysis and cultures.
METHODS
This is a substudy of the multicentre RICAT-trial, a successful quality improvement project to reduce inappropriate use of intravenous and urinary catheters in seven hospitals in the Netherlands. Adult patients with a (central or peripheral) venous or urinary catheter admitted to internal medicine and non-surgical subspecialty wards were eligible for inclusion. Data were collected every other week during baseline (seven months) and intervention periods (seven months). The primary outcome was the proportion of urine cultures performed following a negative urinalysis, i.e. dipstick and/or microscopic analysis, within 24 h.
RESULTS
Between September 2016 and April 2018, we included 3748 patients, of which 3111 (83%) were admitted from the emergency department. Urinalysis and/or urine cultures were obtained in 2610 (70%) of 3748 patients. 626 (23.7%) of 2636 urine cultures and 1351 (55.8%) of 2419 microscopic analysis were unnecessary performed after a negative urinalysis. Cancelling urine testing orders after a negative dipstick would have saved almost € 19.500 during the study period in these seven hospitals.
CONCLUSION
Unnecessary urine testing is frequent in non-surgical patients in the Netherlands. We need to take action to reduce unnecessary urinalysis and cultures, and thereby probably reduce overtreatment of asymptomatic bacteriuria.
Topics: Adult; Bacteriuria; Humans; Netherlands; Urinalysis; Urinary Catheters; Urinary Tract Infections; Urine
PubMed: 32830036
DOI: 10.1016/j.ejim.2020.08.013 -
Scientific Reports Aug 2020Analyzing electrolytes in urine, such as sodium, potassium, calcium, chloride, and nitrite, has significant diagnostic value in detecting various conditions, such as...
Analyzing electrolytes in urine, such as sodium, potassium, calcium, chloride, and nitrite, has significant diagnostic value in detecting various conditions, such as kidney disorder, urinary stone disease, urinary tract infection, and cystic fibrosis. Ideally, by regularly monitoring these ions with the convenience of dipsticks and portable tools, such as cellphones, informed decision making is possible to control the consumption of these ions. Here, we report a paper-based sensor for measuring the concentration of sodium, potassium, calcium, chloride, and nitrite in urine, accurately quantified using a smartphone-enabled platform. By testing the device with both Tris buffer and artificial urine containing a wide range of electrolyte concentrations, we demonstrate that the proposed device can be used for detecting potassium, calcium, chloride, and nitrite within the whole physiological range of concentrations, and for binary quantification of sodium concentration.
Topics: Biosensing Techniques; Calcium; Decision Making; Early Diagnosis; Electrolytes; Humans; Miniaturization; Nitrites; Potassium; Smartphone
PubMed: 32788641
DOI: 10.1038/s41598-020-70456-6 -
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 -
Biosensors Jul 2020Current available methods for the clinical diagnosis of urinary tract infection (UTI) rely on a urine dipstick test or culturing of pathogens. The dipstick test is rapid... (Review)
Review
Current available methods for the clinical diagnosis of urinary tract infection (UTI) rely on a urine dipstick test or culturing of pathogens. The dipstick test is rapid (available in 1-2 min), but has a low positive predictive value, while culturing is time-consuming and delays diagnosis (24-72 h between sample collection and pathogen identification). Due to this delay, broad-spectrum antibiotics are often prescribed immediately. The over-prescription of antibiotics should be limited, in order to prevent the development of antimicrobial resistance. As a result, there is a growing need for alternative diagnostic tools. This paper reviews applications of chemical-analysis instruments, such as gas chromatography-mass spectrometry (GC-MS), selected ion flow tube mass spectrometry (SIFT-MS), ion mobility spectrometry (IMS), field asymmetric ion mobility spectrometry (FAIMS) and electronic noses (eNoses) used for the diagnosis of UTI. These methods analyse volatile organic compounds (VOCs) that emanate from the headspace of collected urine samples to identify the bacterial pathogen and even determine the causative agent's resistance to different antibiotics. There is great potential for these technologies to gain wide-spread and routine use in clinical settings, since the analysis can be automated, and test results can be available within minutes after sample collection. This could significantly reduce the necessity to prescribe broad-spectrum antibiotics and allow the faster and more effective use of narrow-spectrum antibiotics.
Topics: Bacteria; Electronic Nose; Humans; Ion Mobility Spectrometry; Principal Component Analysis; Urinalysis; Urinary Tract Infections; Urine Specimen Collection; Volatile Organic Compounds
PubMed: 32717983
DOI: 10.3390/bios10080083 -
PLoS Neglected Tropical Diseases Jul 2020Melioidosis, caused by Burkholderia pseudomallei, is a severe infectious disease with high mortality rates, but is under-recognized worldwide. In endemic areas, there is...
BACKGROUND
Melioidosis, caused by Burkholderia pseudomallei, is a severe infectious disease with high mortality rates, but is under-recognized worldwide. In endemic areas, there is a great need for simple, low-cost and rapid diagnostic tools. In a previous study we showed, that a protein multiplex array with 20 B. pseudomallei-specific antigens detects antibodies in melioidosis patients with high sensitivity and specificity. In a subsequent study the high potential of anti-B. pseudomallei antibody detection was confirmed using a rapid Hcp1 single protein-based assay. Our protein array also showed that the antibody profile varies between patients, possibly due to a combination of host factors but also antigen variations in the infecting B. pseudomallei strains. The aim of this study was to develop a rapid test, combining Hcp1 and the best performing antigens BPSL2096, BPSL2697 and BPSS0477 from our previous study, to take advantage of simultaneous antibody detection.
METHODS AND PRINCIPAL FINDINGS
The 4-plex dipstick was validated with sera from 75 patients on admission plus control groups, achieving 92% sensitivity and 97-100% specificity. We then re-evaluated melioidosis sera with the 4-plex assay that were previously misclassified by the monoplex Hcp1 rapid test. 12 out of 55 (21.8%) false-negative samples were positive in our new dipstick assay. Among those, 4 sera (7.3%) were Hcp1 positive, whereas 8 (14.5%) sera remained Hcp1 negative but gave a positive reaction with our additional antigens.
CONCLUSIONS
Our dipstick rapid test represents an inexpensive, standardized and simple diagnostic tool with an improved serodiagnostic performance due to multiplex detection. Each additional band on the test strip makes a false-positive result more unlikely, contributing to its reliability. Future prospective studies will seek to validate the gain in sensitivity and specificity of our multiplex rapid test approach in different melioidosis patient cohorts.
Topics: Antibodies, Bacterial; Antigens, Bacterial; Bacterial Proteins; Burkholderia pseudomallei; Humans; Melioidosis; Reagent Strips; Sensitivity and Specificity; Serologic Tests
PubMed: 32658917
DOI: 10.1371/journal.pntd.0008452 -
Annals of Internal Medicine Sep 2020Although measuring albuminuria is the preferred method for defining and staging chronic kidney disease (CKD), total urine protein or dipstick protein is often measured... (Meta-Analysis)
Meta-Analysis
Conversion of Urine Protein-Creatinine Ratio or Urine Dipstick Protein to Urine Albumin-Creatinine Ratio for Use in Chronic Kidney Disease Screening and Prognosis : An Individual Participant-Based Meta-analysis.
BACKGROUND
Although measuring albuminuria is the preferred method for defining and staging chronic kidney disease (CKD), total urine protein or dipstick protein is often measured instead.
OBJECTIVE
To develop equations for converting urine protein-creatinine ratio (PCR) and dipstick protein to urine albumin-creatinine ratio (ACR) and to test their diagnostic accuracy in CKD screening and staging.
DESIGN
Individual participant-based meta-analysis.
SETTING
12 research and 21 clinical cohorts.
PARTICIPANTS
919 383 adults with same-day measures of ACR and PCR or dipstick protein.
MEASUREMENTS
Equations to convert urine PCR and dipstick protein to ACR were developed and tested for purposes of CKD screening (ACR ≥30 mg/g) and staging (stage A2: ACR of 30 to 299 mg/g; stage A3: ACR ≥300 mg/g).
RESULTS
Median ACR was 14 mg/g (25th to 75th percentile of cohorts, 5 to 25 mg/g). The association between PCR and ACR was inconsistent for PCR values less than 50 mg/g. For higher PCR values, the PCR conversion equations demonstrated moderate sensitivity (91%, 75%, and 87%) and specificity (87%, 89%, and 98%) for screening (ACR >30 mg/g) and classification into stages A2 and A3, respectively. Urine dipstick categories of trace or greater, trace to +, and ++ for screening for ACR values greater than 30 mg/g and classification into stages A2 and A3, respectively, had moderate sensitivity (62%, 36%, and 78%) and high specificity (88%, 88%, and 98%). For individual risk prediction, the estimated 2-year 4-variable kidney failure risk equation using predicted ACR from PCR had discrimination similar to that of using observed ACR.
LIMITATION
Diverse methods of ACR and PCR quantification were used; measurements were not always performed in the same urine sample.
CONCLUSION
Urine ACR is the preferred measure of albuminuria; however, if ACR is not available, predicted ACR from PCR or urine dipstick protein may help in CKD screening, staging, and prognosis.
PRIMARY FUNDING SOURCE
National Institute of Diabetes and Digestive and Kidney Diseases and National Kidney Foundation.
Topics: Albuminuria; Creatinine; Female; Humans; Male; Mass Screening; Middle Aged; Prognosis; Proteinuria; Reagent Strips; Renal Insufficiency, Chronic; Sensitivity and Specificity; Urinalysis
PubMed: 32658569
DOI: 10.7326/M20-0529 -
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