Background: Routine urine culture results can be affected by several factors, including variance in methods of specimen collection and the effect of previous or concurrent use of antimicrobial agents on organism viability.
Methods: A retrospective chart review of 73 patients referred for possible UTI. In addition to urine analysis and culture, all urine samples were tested by the TEM-PCR UTI panel which detects 14 bacterial targets.
Results: Patient mean age was 64 years (range 24-94), 63% female. Most common comorbidities include diabetes 30%, urine catheter 26%, cancer 16%, immunosuppressants 11% and renal stone 5%. 33% did not have symptoms. TEM-PCR detected at least one bacterial target in 78% while culture was positive in 53%. Most common organisms detected by TEM-PCR were E. coli, E. faecalis, Klebsiella, Enterobacter and E. facium. Entercoccus was detected more in females than males (61% vs. 19%). The most common organisms detected by urine culture were E. coli, Klebsiella, yeast, Enterococcus and Pseudomonas. Culture showed 13% mixed flora from female samples. Patients with catheters had similar target detection by PCR but urine culture showed more yeast and mixed flora. In those with diabetes, immunosuppressants, cancer or kidney stone there was more detection of organisms by TEM-PCR. In the asymptomatic group TEM-PCR was positive in 45% while culture only 12%. Correlation of urine analysis results with culture and TEM-PCR were mixed. More organisms were identified with both culture and TEM-PCR when WBC was >50/HPF. There was no correlation of hematuria and organisms found by either method. There were more organisms detected with TEM-PCR when epithelial cell counts and nitrites were normal. Culture and PCR matched exactly in 42%, was discordant in 33%, 12% were not in PCR panel and 12% matched partially. There was co-detection of two organisms in 27% and three organisms in 7%. The most common organisms co-detected were E. coli and E. faecalis.
Conclusion: TEM-PCR identifies pathogens more frequently, with more co-detections from urine specimens than culture. Culture identifies a broader variety of organisms where TEM-PCR is limited to 14 organisms in the multiplex panel. Further studies are needed to assess the utility of this test.
D. Hockman, Diatherix: Employee , Salary
M. Huff, Diatherix: Employee , Salary
D. Stalons, Diatherix: Employee , Salary
E. Grigorenko, Diatherix: Employee , Salary
A. Hassoun, None
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