PCR Test Bests Urine Cultures for UTI Pathogen Detection

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A multiplex polymerase chain reaction assay detected bacteria species missed by traditional urine culture as well as more fastidious bacteria.
A multiplex polymerase chain reaction assay detected bacteria species missed by traditional urine culture as well as more fastidious bacteria.
The following article is part of conference coverage from the 2018 Large Urology Group Practice Association meeting in Chicago, November 1-3. Renal and Urology News' staff will be reporting on presentations dealing with various practice management and clinical topics aimed at community-based urologists. Check back for the latest news from LUGPA 2018.

CHICAGO—A multiplex polymerase chain reaction (PCR) test identifies more bacteria than traditional urine culture in patients with symptomatic urinary tract infection (UTI), and it was able to detect more fastidious bacteria, investigators reported at the 2018 annual meeting of the Large Urology Group Practice Association. It also detected the same organisms as traditional culture.

In addition, the PCR test (GUIDANCE), which identifies and quantitates pathogens, can detect organisms that cultures miss, as validated by Next Generation 16-S rRNA Metagenomic Sequencing (NGS). The PCR assay detected more Escherichia coli and Enterococcus faecalis cases, Kirk J. Wojno, MD, of Comprehensive Urology/Michigan Healthcare Professionals, and colleagues reported in a poster presentation.

The PCR assay showed 67% positive correlation, 11% negative correlation, and 22% discordance with NGS, according to the investigators.

For the analysis, investigators collected urine samples from 582 patients aged 60 years or older who were experiencing lower urinary tract symptoms and had indications of cystitis. The PCR test and traditional urine cultures were assayed in parallel. A subset of samples was submitted for NGS. The PCR test detected 22 out of 24 organisms targeted, whereas traditional culture detected 15. “The organisms not detected by traditional culture were primarily those organisms that are considered fastidious either because they are slow growing organisms, or they require supplemental growth conditions to propagate on traditional urine culture plates,” the investigators wrote.

Visit Renal and Urology News' conference section for continuous coverage from LUGPA 2018.

Reference

Wojno KJ, Sirls L, Avaniss-Aghajani E, et al. Multiplex PCR (Guidance) for urinary tract infections identifies more significant pathogens than urine culture—as confirmed by next generation 16S rRNA sequencing. Presented at the 2018 annual meeting of the Large Urology Group Practice Association in Chicago, Nov. 1-3.

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