UTI test often fails to detect infection, study says
| Study finds standard test, widely used since 1950s, often gives false results
| Sarah Boseley, The Guardian – The “gold standard” test for urinary tract infections (UTIs) is not fit for purpose, according to research which suggests that it fails to diagnose most chronic sufferers.
UTIs afflict an estimated 150-200 million people around the world every year.
While many, particularly young women, suffer acute attacks of cystitis, which is quickly resolved with a few days of antibiotics, chronic infection can stay with people for many years and wreak havoc with their lives.
Those who suffer most tend to be older women, who may be sent home time and again by the doctor because the UTI test is negative.
But the test, which has been around since the 1950s and was adopted all over the world, is flawed, says Dr. Jennifer Rohn, head of Urological Biology at University College London.
Her team compared the results of the standard test – the midstream urine culture (MSU) – with DNA sequencing for 33 new patients with symptoms, 30 who were experiencing a relapse after having been treated and 29 controls with no symptoms.
Their research, published in the Journal of Clinical Microbiology, found only six of the MSU tests were positive, while the DNA test identified infection in all the patients with symptoms.
“This work put the MSU head-to-head with modern DNA analysis methods – and it failed spectacularly,” said Rohn. “On the other hand, genomic sequencing using enriched urine specimens easily managed to pick out people who were genuinely ill.
“This paper shows that the MSU is unsuitable for excluding UTI in patients with lower urinary tract symptoms. Therefore, we urgently need to develop alternative rapid diagnostic tests to take its place.” Read more.
Scientific background …
MEDSCAPE – This integrative review explores current evidence on microbiota of the female urinary tract as it relates to overactive bladder (OAB) symptoms. Six articles were identified for review. Findings suggest a possible link between the female urinary microbiome and OAB symptom presentation.
The medical world has long upheld the notion that the female bladder is sterile. Recent studies provide evidence that this might not be the case.
Bacterial DNA has been detected in the urine of women who have lower urinary tract symptoms (LUTS) and those who do not, suggesting an intrinsic microbiome of the female urinary tract (Brubaker & Wolfe, 2015; Hilt et al., 2014; Wolfe et al., 2012).
The National Institutes of Health (NIH) Human Microbiome Project (2015) defines microbiome as the collection of microorganisms living in the human body, including eukaryotes, archaea, bacteria, and viruses.
These discoveries could lead to new insights into little-understood women’s health issues, including recurrent urinary tract infections (UTIs), and LUTS, including overactive bladder (OAB) (Brubaker & Wolfe, 2015).
Traditional urine cultures do not detect all bacteria present in the urine, resulting in many negative culture UTIs going undiagnosed and untreated.
New findings of bacteria present on traditionally negative urine cultures challenge the current practice of urine culturing and diagnosis, and present a need for new definitions, expanded culturing, and treatment options.
This new information presents a paradigm shift in the scientific understanding of the female bladder. Read more.