Evaluation of the efficiency of URO-QUICKTM System in the Detection of Urinary Tract Infections and use of Fluorescence In-Situ Hybridization (FISH) In Detection of Escherichia coli in Urine

Background: Urinary tract infection (UTI) is outlined as a significant number of pathogenic organisms within the urinary system. The URO-QUICK system relies on a light-scattering technique that steadfastly detects microbial growth in fluid samples, giving real-time growth curves and bacterial counts (cfu/ml). The system was initially designed for the fast screening of urine samples. The sensitivity of the system, expressed in terms of cfu/ml, depends on the time of detection, therefore if it is intended to detect 100, 00cfu/ml, and the time required for detection is 180 min. Early detection of microbial pathogens is crucial for rational and conservative antibiotic use particularly within the case of known local resistance patterns. Fluorescence in situ hybridization (FISH) with rRNA-targeted oligonucleotide probes enables the fast and specific detection of individual microbial cells from urine samples. Objective: to evaluate the URO-QUICK system in comparison with conventional culture methods and utilize fluorescence in situ hybridization (FISH) for early detection of E .coli in urine Methodology: A total of 1016 urine samples were collected from different hospitalized patients in Urology & Nephrology Center, Mansoura University. The specimens were cultured by standard methods. 0.5 mL of well-mixed urine was inoculated in Uro-Quick broth vials which were subsequently applied to the Uro-Quick instrument and incubated for a maximum of 3h. Results: 214(21%) samples were positive by conventional culture; bacterial identification was performed with automated VITEK 2 system. 113(52%) samples were E. coli, 36(16.8%) samples were Klebsiella pneumoniae, 19(8.9%) samples were Pseudomonas aeruginosa, 5(2.4%) samples were Proteus mirabilis, 3(1.4%) Enterobacter cloacae, 2(0.9) samples were Morganella morganii, 1(0.5%) sample was Citrobacter freundii, 1(0.5%) sample was Acinetobacter baumannii, 19(8.9%) samples were Enterococcus faecalis, 2(0.9%) samples were Streptococcus pneumoniae, 2(0.9%) samples were Staphylococcus aureus, and 11(5.1%) samples were Candida albicans. 220(21.6%) samples were positive by Uro-Quick Screening test. Miacom's uriFISH Screen for E. coli used for the complementary positions targeting position 342–357 in E. coli 16S rRNA (5’-CTGCTGCCTCCCGTAG-3’). From 220 positive samples by Uro-Quick Screening test, Miacom's uriFISH Screen for E. coli yielded only 113 positive samples from urine samples. Conclusion: The Uro-Quick screening system seems to be a reliable instrument to obtain urine microbiological results in a timely manner and FISH technique able to specifically detect pathogens quantitatively in situ even in samples containing mixtures of bacteria.