Electrochemical biosensors for the detection of urinary tract infections

Electrochemical biosensors have emerged as promising tools to address major limitations of conventional urinary tract infection (UTI) diagnosis, which depends on slow culture and low-specificity dipsticks. By transducing specific biorecognition events into electrical signals, these platforms can deliver rapid, sensitive, and potentially point of care results directly from urine. This narrative review synthesizes developments in pathogen directed and host response based electrochemical biosensors for UTI detection. DNA biosensor arrays targeting bacterial 16S rRNA enable species specific identification of common and polymicrobial uropathogens within ∼1 h, with reported sensitivities around 89-100% and specificities up to 100% in clinical urine samples. Integrated lab on chip and array systems further extend this approach to rapid phenotypic antimicrobial susceptibility testing and minimum inhibitory concentration determination, substantially shortening time to targeted therapy. In parallel, several platforms quantify urinary host biomarkers, such as lactoferrin and prostaglandin E2, as objective measures of pyuria and inflammatory response. These include impedance based aptasensors, sandwich immunosensors, and novel electrofluidic capacitor or lateral flow electrochemical formats that operate label free in small volumes of unprocessed urine and can discriminate UTI positive from UTI negative samples within minutes. Emerging designs also target specific pathogens (e.g., Klebsiella pneumoniae, Enterococcus faecium) or live bacteria via phage recognition, nanostructured electrodes, molecular imprinting, and DNAzyme based amplification. The review highlights analytical performance, clinical validation, and translational challenges including matrix effects, multiplexing needs, and integration for home or point of care use framing electrochemical biosensors as key candidates for next generation, rapid, and more informative UTI diagnostics.