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Utility of enhanced quantitative urine culture technique for isolation of uro-pathogens in children
Kavita Gupta1, Prashanth Purushotham2, Nischitha Vallurupalli1
1Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Insights
Enhanced quantitative urine culture (EQUC) identifies more uropathogens in children than standard urine culture (SUC). This improved diagnostic method aids in better management of pediatric urinary tract infections (UTIs).
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Diagnostic Methods
Background:
- Urinary tract infections (UTIs) are common worldwide, but diagnosis in children is challenging due to vague symptoms and underdiagnosis.
- Standard urine culture (SUC) is the gold standard but has limitations in guiding antimicrobial therapy decisions.
- Enhanced quantitative urine culture (EQUC) was developed to improve UTI detection, but its use in pediatrics requires further investigation.
Purpose of the Study:
- To evaluate the utility of Enhanced quantitative urine culture (EQUC) for isolating bacterial uropathogens in pediatric patients.
- To compare the diagnostic performance of EQUC against Standard urine culture (SUC) in children.
Main Methods:
- A prospective observational study involving 156 urine samples from 84 pediatric patients.
- Urine samples were processed using both Standard urine culture (SUC) and Enhanced quantitative urine culture (EQUC) techniques.
- Microbial identification and antimicrobial susceptibility testing were performed using phenotypic characteristics, biochemical tests, and the VITEK 2 SYSTEM.
Main Results:
- Enhanced quantitative urine culture (EQUC) identified significantly more positive samples (55.7%) compared to Standard urine culture (SUC) (32.05%).
- EQUC recovered 25% more uropathogenic organisms than SUC, with Escherichia coli being the most common isolate.
- Patient management based on EQUC results showed improved recovery rates across all pediatric age groups, particularly with midstream urine samples.
Conclusions:
- Enhanced quantitative urine culture (EQUC) demonstrates superior recovery rates for uropathogens compared to Standard urine culture (SUC).
- EQUC is a valuable and effective diagnostic tool for identifying bacterial uropathogens in pediatric urinary tract infections (UTIs).
- The findings support the increased utility of EQUC in diagnosing and managing pediatric UTIs.
Background:
Urinary tract infections (UTIs) are the most common bacterial infection worldwide. Symptoms of UTI in children is vague & non-specific and mostly underdiagnosed Standard urine culture (SUC) is the gold standard for detecting uropathogens but the clinical correlation and its implication in initiating antimicrobial therapy continue to be a question for decision-making. Enhanced quantitative urine culture (EQUC) was developed to overcome these limitations. However, its utility to diagnose paediatric UTI has not been well explored, necessitating the need for new diagnostic methods. The study was conducted to evaluate the utility of EQUC for isolation of bacterial uropathogens in children.
Method:
A prospective observation study was conducted and urine samples were collected and processed using both SUC and EQUC techniques. Microbial identification was performed using phenotypic characteristics and biochemical tests. VITEK 2 SYSTEM was used for identification and antimicrobial susceptibility testing whenever required.
Results:
A total of 156 samples were collected from 84 patients and subjected to SUC and EQUC techniques. SUC identified 50 positive samples (32.05%), while EQUC identified 87 positive samples (55.7%). EQUC recovered 25% more organisms compared to SUC. Escherichia coli was the most common organism isolated in both the techniques. Management of patients considering EQUC results showed better recovery in all age groups especially for midstream urine.
Conclusion:
The EQUC technique demonstrated higher recovery rates of uro-pathogens compared to the SUC, making it a valuable tool for diagnosing paediatric UTIs.
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