Comparison of Bacterial Culture and Microscopic Urine Analyzer in the Urinary Tract Infections

Abstract

Objective: The urine culture is the gold standard for diagnosis of urinary tract infection. Fully automated urine analyzer (FAUA) which gives quantitative results is also commonly used for urinalysis. This device identifies erythrocytes, leukocytes and epithelial cells as well as bacteria and renal elements performing a microscopic analysis. The aim of this retrospective study is to compare urine cultures with the FAUA used by the clinicians for rapid diagnosis of urinary tract infections. Methods: A total number of 23 065 urine specimens sent from various clinics to the Microbiology and Clinical Microbiology Laboratory in our hospital for both urinalysis and urinary culture between the dates of 1 June 2010 and 31 October 2011 were evaluated. Urinalysis was performed with iQ (R) 200 (Iris Diagnostics, Chatsworth, CA, USA). The FAUA values with >= 5 leukocytes and >= 1 bacteria were classified as FAUA-positive. Urine cultures growing >= 5x10(4) cfu/ml were included in the comparison. Results: Of the total FAUA and culture results, 11.7% were incompatible in terms of the number of leukocytes including leukocytenegative/culture-positive (0.4%) and leukocyte-positive/culturenegative (11.3%) results, and 6.6% were incompatible in terms of the number of germs including culture-positive/germ-negative (5%) results and germ-positive/culture-negative (1.6%) results. Conclusions: FAUA often used by clinicians for rapid diagnosis of urinary tract infection will contribute to the evaluation of the culture in a more efficient way, however, it should not replace the urine culture.