Evaluation of an automated urinalysis system for testing urine chemistry, microscopy and culture

This study was designed to evaluate the performance of an automated urinalysis system that utilised three commercially available instruments, the Clinitek Atlas, Sysmex UF-100 and the Alifax Uro-Quick.

The results of the automated system for 818 urine samples were compared with the results of manual processing which consisted of phase contrast microscopy, manual dipstick chemistry analysis and culture onto solid media.

The correlation between the two methods for urine chemistry was excellent with a concordance of 89, 97, 100 and 98% for pH, blood, glucose and protein, respectively. The quantification of red blood cells and white blood cells had an R2 of 0.855 and 0.92, respectively. A difference scatter plot indicated a trend towards the manual cell count being greater than the UF-100 count as both the red and white blood cell count increased. There was 98% agreement between the automated process and manual culture.

The automated urinalysis system is fully integrated and allows for the cross-checking of urine chemistry and microscopy as well as electronic transfer of data. The automated process was used as a screening procedure and some manual testing was necessary. Automation of urinalysis offers a reduction in variation and has comparable results to manual testing.