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...

Full description

Saved in:
Bibliographic Details
Main Authors: Adrien Biguenet, Elisa Champy, Marine Gilis, Houssein Gbaguidi-Haore, Isabelle Patry, Kévin Bouiller, Xavier Bertrand
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Geriatrics
Subjects:
Online Access:https://doi.org/10.1186/s12877-025-06063-9
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849434237331046400
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
record_format Article
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
work_keys_str_mv AT adrienbiguenet urineflowcytometryinolderadultsurinarytractinfectiondiagnosisisittimetoreevaluatethresholdsformenandwomen
AT elisachampy urineflowcytometryinolderadultsurinarytractinfectiondiagnosisisittimetoreevaluatethresholdsformenandwomen
AT marinegilis urineflowcytometryinolderadultsurinarytractinfectiondiagnosisisittimetoreevaluatethresholdsformenandwomen
AT housseingbaguidihaore urineflowcytometryinolderadultsurinarytractinfectiondiagnosisisittimetoreevaluatethresholdsformenandwomen
AT isabellepatry urineflowcytometryinolderadultsurinarytractinfectiondiagnosisisittimetoreevaluatethresholdsformenandwomen
AT kevinbouiller urineflowcytometryinolderadultsurinarytractinfectiondiagnosisisittimetoreevaluatethresholdsformenandwomen
AT xavierbertrand urineflowcytometryinolderadultsurinarytractinfectiondiagnosisisittimetoreevaluatethresholdsformenandwomen