Urinary tract infections (UTIs)
 

Urinary tract infections (UTIs) are considered among the most prevalent diseases globally, affecting approximately 400 million people and resulting in 240,000 deaths each year.¹

While most UTIs are considered uncomplicated and common, there is another type of UTI that can be more serious. A complicated UTI has a higher risk of treatment failure and recurrence. Severe cases can lead to urosepsis and can be fatal. Identifying the causative agent and determining susceptibility are paramount to treating these cases.

Although widely used, culture-based urine testing methods for the detection of urinary tract pathogens are cumbersome. They require up to 30 hours of culturing time, lack sensitivity, are subjective, and have been shown to miss a significant percentage of positive cases.

Real-time PCR (qPCR), especially when paired with standard culture methods, has shown clinical evidence for molecular detection of UTI pathogens to support effective patient outcomes.

• Some urinary pathogens are slow-growing and difficult to culture
• As many as 39% of UTI cases are polymicrobial²
• Unnecessary prescribing of antibiotics without knowing the pathogen causing the infection can lead to drug resistance

Benefits of molecular testing
 

Real-time PCR (qPCR), especially when paired with standard culture methods, has clinical evidence for molecular detection of UTI pathogens to support effective patient outcomes³. PCR can be performed to target a single pathogen, or multiplex PCR can simultaneously detect multiple targets and organisms in a single reaction. Such simultaneous detection of various pathogens could aid clinical decision-making, allowing quicker and more specific treatments, which may lead to fewer recurrent infections resulting from inadequate or inappropriate treatments⁴. PCR can also be performed in the context of large syndromic panels that can be designed to identify a wide range of possible targets. Such panels are molecular tests that detect more than one pathogen associated with similar and overlapping clinical symptomatology⁵.

Testing methods
 

Pathogens causing urinary tract infections
 

Contact us

Educational resources
 

Videos

Watch these short videos and explore the considerations for UTI diagnosis and management with Dr. Mohit Mathur, Chief Medical Officer of Pathnostics.

References:
 

1.     Yang X, Chen H, et al. (2022) Disease burden and long-term trends of urinary tract infections: A worldwide report. Front. Public Health 10:888205. doi: 10.3389/fpubh.2022.888205

2.     Laudisio A, Marinosci F, et al. The burden of comorbidity is associated with symptomatic polymicrobial urinary tract infection among institutionalized elderly. Aging Clin Exp Res. 2015;27(6):805-812. doi:10.1007/s40520-015-0364-x

3.     Ashok, A., Ko, D., et al. (2022). Comparison of guidance UTI® and standard urine culture for rates of sepsis, hospitalization and other adverse outcomes in complicated urinary tract infections. Journal of Urology, 207(Supplement 5), e550. https://doi.org/10.1097/ju.0000000000002583.09

4.     Wojno KJ, Baunoch D, et al. Multiplex PCR Based Urinary Tract Infection (UTI) Analysis Compared to Traditional Urine Culture in Identifying Significant Pathogens in Symptomatic Patients. Urology. 2020;136:119-126. doi:10.1016/j.urology.2019.10.018

5.     Centers for Medicare & Medicaid Services. (2022). MolDX: Molecular syndromic panels for infectious disease pathogen identification testing. Centers for Medicare & Medicaid Services. https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39001&ver=4

6.     Klipp J (2022) Spotlight interview: Pathnostics' CEO Dave Pauluzzi. Laboratory Economics 17(7). https://pathnostics.com/wp-content/uploads/2022/07/Pathnostics.LE_.Reprint.pdf

7.     The qPCR Ecosystem and State of qPCR in Molecular Diagnostics  https://thermofisher.com/blog/clinical-conversations/the-qpcr-ecosystem-and-state-of-qpcr-in-molecular-diagnostics/