title: Rapid qualitative urinary tract infection pathogen identification by SeptiFast real-time PCR.
abstract: BACKGROUND
  Urinary tract infections (UTI) are frequent in outpatients. Fast pathogen identification is mandatory for shortening the time of discomfort and preventing serious complications. Urine culture needs up to 48 hours until pathogen identification. Consequently, the initial antibiotic regimen is empirical.
  
  
  OBJECTIVE
  To evaluate the feasibility of qualitative urine pathogen identification by a commercially available real-time PCR blood pathogen test (SeptiFast®) and to compare the results with dipslide and microbiological culture.
  
  
  METHODS
  Pilot study with prospectively collected urine samples.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  82 prospectively collected urine samples from 81 patients with suspected UTI were included. Dipslide urine culture was followed by microbiological pathogen identification in dipslide positive samples. In parallel, qualitative DNA based pathogen identification (SeptiFast®) was performed in all samples.
  
  
  RESULTS
  61 samples were SeptiFast® positive, whereas 67 samples were dipslide culture positive. The inter-methodological concordance of positive and negative findings in the gram+, gram- and fungi sector was 371/410 (90%), 477/492 (97%) and 238/246 (97%), respectively. Sensitivity and specificity of the SeptiFast® test for the detection of an infection was 0.82 and 0.60, respectively. SeptiFast® pathogen identifications were available at least 43 hours prior to culture results.
  
  
  CONCLUSIONS
  The SeptiFast® platform identified bacterial DNA in urine specimens considerably faster compared to conventional culture. For UTI diagnosis sensitivity and specificity is limited by its present qualitative setup which does not allow pathogen quantification. Future quantitative assays may hold promise for PCR based UTI pathogen identification as a supplementation of conventional culture methods.
authors.affiliation: University Department of Anaesthesiology and Pain Therapy, Inselspital, Bern University, Bern, Switzerland.
authors.forename: Lutz E
authors.initials: LE
authors.lastname: Lehmann
authors.forename: Stefan
authors.initials: S
authors.lastname: Hauser
authors.forename: Thomas
authors.initials: T
authors.lastname: Malinka
authors.forename: Sven
authors.initials: S
authors.lastname: Klaschik
authors.forename: Stefan U
authors.initials: SU
authors.lastname: Weber
authors.forename: Jens-Christian
authors.initials: JC
authors.lastname: Schewe
authors.forename: Frank
authors.initials: F
authors.lastname: Stüber
authors.forename: Malte
authors.initials: M
authors.lastname: Book
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D001419:Bacteria / Q000235:genetics / Q000472:pathogenicity; D001424:Bacterial Infections / Q000175:diagnosis / Q000382:microbiology / Q000652:urine; D015331:Cohort Studies; D003199:Computer Systems; D004269:DNA, Bacterial / Q000032:analysis*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D013997:Time Factors; D016482:Urinalysis / Q000379:methods*; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000382:microbiology* / Q000652:urine; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial