Evaluation of automated microscopy sediment analysis in urinary tract infection screening: a practical insight in adjusting fixed cut-off values for urine culture

PurposeThe aim of our study was to evaluate a procedure in which urine culture was only being performed based on fixed cut-off values of urine sediment analysis with intention to prevent unnecessary negative urine cultures.MethodsFrom January 2018 to August 2018, all urine samples from patients visiting the urology outpatient department were analyzed. Urine culture was only performed if urine sediment contained more than 130 bacteria per microliter and/or more than 50 leukocytes per microliter.ResultsIn total, 2821 urine cultures with accompanying urine sediments were analyzed. 2098 cultures (74.4%) were defined negative and 723 (25.6%) positive. By adjusting cut-off values of sediment analysis > 20 per microliter or bacteria more than 330 per microliter, 1051 cultures would have been saved with an estimated cost reduction of euro 31.470. Eleven clinically relevant urine cultures would have been missed (1%).ConclusionUsing cut-offs values leads to a notable decrease of the total number of urine cultures. According to our analysis, adjusting cut-off values could result in 37% less urine cultures and almost 50% less negative cultures. Hereby, unnecessary cost can be prevented [in our department estimated euro31.470 in eight months (euro 47.205/year)].

Automated summary

The study aimed to evaluate a procedure in which urine culture was performed based on fixed cut-off values of urine sediment analysis to prevent unnecessary negative urine cultures. Urine samples were analyzed from January 2018 to August 2018 in the urology outpatient department. Results showed that adjusting the cut-off values of sediment analysis could significantly reduce the number of urine cultures and unnecessary costs.