Rapid screening of urinary tract infections: quantitative flow cytometry versus dipstick testing in a hospital cohort.

Authors

B Dirk, T Hwandih, M Holz, B Schönbeck, L von Müller

Published in

Infection. Aug 11, 2026. Epub Aug 11, 2026.

Abstract

We compared urine dipstick testing (DS) with quantitative flow cytometry (FC) and evaluated a diagnostic algorithm to optimise urinary tract infection (UTI) screening.
In this single-centre study, 5,124 consecutive urine samples were analysed in parallel using DS and FC. Semi-quantitative urine culture was performed for samples with bacterial count (BC) ≥ 100/µL; samples below this threshold were classified as non-UTI without culture confirmation.
A BC ≥ 100/µL was observed in 2,281 samples (44.5%); among these, 1,368 were culture-confirmed as UTI, corresponding to 26.7% of all samples. FC outperformed DS, demonstrating higher sensitivity and specificity while reducing the need for follow-up cultures by 18%. The probability of UTI increased with rising BC and exceeded 90% at BC values ≥ 3,000/µL, particularly in samples without evidence of contamination. BC was significantly higher in Gram-negative than in Gram-positive infections (median 19,610 vs. 679/µL). Sample contamination was associated with elevated squamous cell counts (SQC ≥ 10/µL).
FC with direct bacterial detection demonstrates superior performance compared with DS for both ruling in and ruling out UTIs. Quantitative FC parameters enable early estimation of UTI probability and sample contamination prior to culture results, supporting diagnostic stewardship and enabling earlier targeted clinical decision-making.

PMID:
42579066
Bibliographic data and abstract were imported from PubMed on 11 Aug 2026.

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