Urine flow cytometry in older adults urinary tract infection diagnosis: is it time to reevaluate thresholds for men and women?
Abstract Background To evaluate the utility of automated urine flow cytometry in the diagnosis of urinary tract infection (UTI) in older patients without waiting for urine culture results. Methods This prospective study included patients aged ≥ 65 years admitted to the emergency department of Besanç...
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BMC
2025-06-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-025-06063-9 |
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| author | Adrien Biguenet Elisa Champy Marine Gilis Houssein Gbaguidi-Haore Isabelle Patry Kévin Bouiller Xavier Bertrand |
| author_facet | Adrien Biguenet Elisa Champy Marine Gilis Houssein Gbaguidi-Haore Isabelle Patry Kévin Bouiller Xavier Bertrand |
| author_sort | Adrien Biguenet |
| collection | DOAJ |
| description | Abstract Background To evaluate the utility of automated urine flow cytometry in the diagnosis of urinary tract infection (UTI) in older patients without waiting for urine culture results. Methods This prospective study included patients aged ≥ 65 years admitted to the emergency department of Besançon University Hospital over a six-month period. Clinical and biological data were collected and UTI diagnosis was based on strict clinical and biological criteria. Urine analysis was performed using the UF-4000 (Sysmex). Parameters or thresholds were defined based on an AUC > 0.8 and a clinically relevant negative likelihood ratio (LR-) < 0.1. Results Of 456 patients, 69 (15.1%) had a UTI. Bacteriuria (AUC = 0.874) and leukocyturia (AUC = 0.925) were strongly associated with UTI, with thresholds of 150 bacteria/µL and 50 leukocytes/µL (both LR- < 0.1). These cut-offs varied by sex. Urine dipsticks effectively excluded UTI in men (LR- < 0.1), but were less reliable in women (LR- = 0.129). Gender-specific diagnostic algorithms were suggested. Conclusions Urine flow cytometry provides valuable diagnostic thresholds for bacteriuria and leukocyturia and helps to exclude UTI before culture results. Recommendations for the diagnosis of UTI in older patients should take into account gender differences. |
| format | Article |
| id | doaj-art-edfb1a62a92d4f4cb442fb614766ac70 |
| institution | Kabale University |
| issn | 1471-2318 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
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| series | BMC Geriatrics |
| spelling | doaj-art-edfb1a62a92d4f4cb442fb614766ac702025-08-20T03:26:43ZengBMCBMC Geriatrics1471-23182025-06-0125111010.1186/s12877-025-06063-9Urine flow cytometry in older adults urinary tract infection diagnosis: is it time to reevaluate thresholds for men and women?Adrien Biguenet0Elisa Champy1Marine Gilis2Houssein Gbaguidi-Haore3Isabelle Patry4Kévin Bouiller5Xavier Bertrand6UMR-CNRS 6249, Chrono-environnement, Université de Franche-ComtéService d’hygiène hospitalière, CHU de BesançonService de gériatrie, CHU de BesançonService d’hygiène hospitalière, CHU de BesançonService bactériologie médicale, CHU de BesançonUMR-CNRS 6249, Chrono-environnement, Université de Franche-ComtéUMR-CNRS 6249, Chrono-environnement, Université de Franche-ComtéAbstract Background To evaluate the utility of automated urine flow cytometry in the diagnosis of urinary tract infection (UTI) in older patients without waiting for urine culture results. Methods This prospective study included patients aged ≥ 65 years admitted to the emergency department of Besançon University Hospital over a six-month period. Clinical and biological data were collected and UTI diagnosis was based on strict clinical and biological criteria. Urine analysis was performed using the UF-4000 (Sysmex). Parameters or thresholds were defined based on an AUC > 0.8 and a clinically relevant negative likelihood ratio (LR-) < 0.1. Results Of 456 patients, 69 (15.1%) had a UTI. Bacteriuria (AUC = 0.874) and leukocyturia (AUC = 0.925) were strongly associated with UTI, with thresholds of 150 bacteria/µL and 50 leukocytes/µL (both LR- < 0.1). These cut-offs varied by sex. Urine dipsticks effectively excluded UTI in men (LR- < 0.1), but were less reliable in women (LR- = 0.129). Gender-specific diagnostic algorithms were suggested. Conclusions Urine flow cytometry provides valuable diagnostic thresholds for bacteriuria and leukocyturia and helps to exclude UTI before culture results. Recommendations for the diagnosis of UTI in older patients should take into account gender differences.https://doi.org/10.1186/s12877-025-06063-9Urinary tract infectionElderlyDiagnosisFlow cytometryUrine culture |
| spellingShingle | Adrien Biguenet Elisa Champy Marine Gilis Houssein Gbaguidi-Haore Isabelle Patry Kévin Bouiller Xavier Bertrand Urine flow cytometry in older adults urinary tract infection diagnosis: is it time to reevaluate thresholds for men and women? BMC Geriatrics Urinary tract infection Elderly Diagnosis Flow cytometry Urine culture |
| title | Urine flow cytometry in older adults urinary tract infection diagnosis: is it time to reevaluate thresholds for men and women? |
| title_full | Urine flow cytometry in older adults urinary tract infection diagnosis: is it time to reevaluate thresholds for men and women? |
| title_fullStr | Urine flow cytometry in older adults urinary tract infection diagnosis: is it time to reevaluate thresholds for men and women? |
| title_full_unstemmed | Urine flow cytometry in older adults urinary tract infection diagnosis: is it time to reevaluate thresholds for men and women? |
| title_short | Urine flow cytometry in older adults urinary tract infection diagnosis: is it time to reevaluate thresholds for men and women? |
| title_sort | urine flow cytometry in older adults urinary tract infection diagnosis is it time to reevaluate thresholds for men and women |
| topic | Urinary tract infection Elderly Diagnosis Flow cytometry Urine culture |
| url | https://doi.org/10.1186/s12877-025-06063-9 |
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