title: New and developing diagnostic technologies for urinary tract infections.
abstract: Timely and accurate identification and determination of the antimicrobial susceptibility of uropathogens is central to the management of UTIs. Urine dipsticks are fast and amenable to point-of-care testing, but do not have adequate diagnostic accuracy or provide microbiological diagnosis. Urine culture with antimicrobial susceptibility testing takes 2-3 days and requires a clinical laboratory. The common use of empirical antibiotics has contributed to the rise of multidrug-resistant organisms, reducing treatment options and increasing costs. In addition to improved antimicrobial stewardship and the development of new antimicrobials, novel diagnostics are needed for timely microbial identification and determination of antimicrobial susceptibilities. New diagnostic platforms, including nucleic acid tests and mass spectrometry, have been approved for clinical use and have improved the speed and accuracy of pathogen identification from primary cultures. Optimization for direct urine testing would reduce the time to diagnosis, yet these technologies do not provide comprehensive information on antimicrobial susceptibility. Emerging technologies including biosensors, microfluidics, and other integrated platforms could improve UTI diagnosis via direct pathogen detection from urine samples, rapid antimicrobial susceptibility testing, and point-of-care testing. Successful development and implementation of these technologies has the potential to usher in an era of precision medicine to improve patient care and public health.
authors.affiliation: Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive S-287, Stanford, California 94305 USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Davenport
authors.affiliation: Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive S-287, Stanford, California 94305 USA.
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Mach
authors.affiliation: Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive S-287, Stanford, California 94305 USA.
authors.forename: Linda M Dairiki
authors.initials: LMD
authors.lastname: Shortliffe
authors.affiliation: Department of Pathology, Stanford University School of Medicine, 3375 Hillview Avenue, Palo Alto, California 94304 USA.
authors.forename: Niaz
authors.initials: N
authors.lastname: Banaei
authors.affiliation: Departments of Mechanical and Biomedical Engineering, Johns Hopkins University, 3400 N. Charles Street, Baltimore, Maryland 21218, USA.
authors.forename: Tza-Huei
authors.initials: TH
authors.lastname: Wang
authors.affiliation: Department of Urology, Stanford University School of Medicine, 300 Pasteur Drive S-287, Stanford, California 94305 USA.|Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, California 94304 USA.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Liao
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D019411:Clinical Laboratory Techniques / Q000379:methods / Q000639:trends*; D024881:Drug Resistance, Bacterial / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D013677:Medical Laboratory Science / Q000379:methods / Q000639:trends; D046210:Microfluidic Analytical Techniques / Q000379:methods / Q000639:trends; D016133:Polymerase Chain Reaction / Q000379:methods / Q000639:trends; D016482:Urinalysis / Q000379:methods / Q000639:trends; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000652:urine
chemical_list: D000900:Anti-Bacterial Agents