Comparison Shows that Multiplex Polymerase Chain Reaction Identifies Infection-associated Urinary Biomarker-positive Urinary Tract Infections That Are Missed by Standard Urine Culture

• Published in: European urology open science (Online) 2023-12, Vol.58, p.73-81
• Main Authors: Haley, Emery, Luke, Natalie, Mathur, Mohit, Festa, Richard A, Wang, Jimin, Jiang, Yan, Anderson, Lori, Baunoch, David
• Format: Article
• Language: English
• Subjects: Diagnostic testing; False negative urine culture; Infections; Multiplex polymerase chain reaction; Standard urine culture; Urinary tract infection; Urine biomarkers
• ISSN: 2666-1683; 2666-1691; 2666-1683
• DOI: 10.1016/j.euros.2023.10.008

Multiplex polymerase chain reaction (M-PCR) has increased sensitivity for microbial detection compared with standard urine culture (SUC) in cases diagnosed as urinary tract infections (UTIs), leading to questions whether detected microbes are likely causative of UTIs or are incidental findings. To compare infection-associated biomarker levels against M-PCR and SUC results in symptomatic cases with a presumptive diagnosis of a UTI by a urologist. Participants were ≥60 yr old and presented to urology clinics between January and April 2023 with symptoms of UTIs (  = 583). Urine microbial detection was by M-PCR and SUC. Three infection-associated biomarkers (neutrophil gelatinase-associated lipocalin, interleukin-8, and interleukin-1β) were measured by enzyme-linked immunosorbent assay. Symptomatic cases with elevated biomarkers, detection of uropathogens, and a specialist clinical diagnosis of a UTI were considered definitive UTI cases. Distributions were compared using two-sample Wilcoxon rank sum test, with two-tailed values of