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Potential New Screen for UTIs

Clinician's Brief (Capsule)

Clinical Pathology

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March 2014

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Microscopic urine sediment examination, common in-clinic screening method for diagnosing urinary tract infections (UTI), is predictive of infection when coupled with urine culture and urinalysis bacterial results. It is only useful, however, when bacteria numbers in unstained urine are >10,000 rods/mL or >100,000 cocci/mL. The Accutest Uriscreen is a catalase-based test for detection of bacteriuria and pyuria. These enzymes are found in most bacteria that infect the urinary tract as well as within somatic cells. It is currently used as a screening test for UTI in humans, but has not been validated for use in dogs and cats.

In this study, 165 urine samples were evaluated for UTI based on bacterial culture, sediment evaluation, or Uriscreen. Twenty-seven samples were positive on bacterial culture; 24 of these tested positive with the Uriscreen. Of the 138 samples that cultured negative, 98 were negative on the Uriscreen (specificity, 71%). The Uriscreen was found to be more sensitive than sediment evaluation for the detection of UTI (89% vs 78%, respectively). False-positive results were common, but UTI was unlikely if results were negative. Limitations include the need for a urine culture and the potential for false-positive results caused by somatic cells in the absence of bacteria or presence of dysplastic cells.

Commentary

The Uriscreen test may be useful, especially in cases of occult UTI associated with upper urogenital tract infection or increased morbidity. Unfortunately, the test could add to cost without contributing greatly to the diagnostic or prognostic plan, as it has a high number of false-positive and false-negative results. There is no perfect test for urine. The Uriscreen may improve positive predictability of UTI when used with a routine urinalysis while waiting on urine culture results.—Heather Troyer, DVM, DABVP, CVA

Source

Evaluation of a catalase-based urine test for the detection of urinary tract infection in dogs and cats. Kvitko-White HL, Cook AK, Nabity MB, et al. JVIM 10.1111/jvim.12196

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