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Abstract: SA-PO1037

Rapid Diagnosis of Urinary Tract Infection by Flow Cytometry-Based Urine Analyser

Session Information

Category: Pathology and Lab Medicine

  • 1800 Pathology and Lab Medicine


  • Supasyndh, Ouppatham, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Tanaboriboon, Patid, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Punchucherd, Thanapat, Sysmex Thailand Co.,Ltd, Bangkok, Thailand

Group or Team Name

  • Division of Nephrology, Dept of Medicine, Phramongkutklao Hospital, Bangkok, Thailand.

Urinary tract infections (UTIs) are important healthcare problems for hospitalized and community patients. Various bacterial species can cause UTI, the most common of which is the Gram-negative bacilli Escherichia coli. The gold standard for UTI diagnosis remains urine culture, followed by antibiotic sensitivity testing. However, it takes around 48 hours for urine culture to be reported. Therefore, a rapid screening test for UTI is highly desirable to guide clinical decision-making. The Sysmex UF-5000 is a flow cytometry-based automated urine analyzer capable of providing WBC and bacterial counts and the Gram staining of the causative bacteria that positive impact on the rate of antimicrobial resistance. Our prospective cohort study aims to validate the automated flow cytometric analysis using Sysmex UF-5000 for rapid UTI screening and discrimination of gram-positive and gram-negative bacteria, compared to urine culture and conventional Gram staining.


Midstream urine samples from patients with suspected UTIs were collected in sterile containers. They were then subjected to analysis by Sysmex UF-5000 automated urine analyzer, conventional Gram staining, and urine culture. The correlation and agreement between the different methods were then determined and ROC curve analysis was performed where appropriate.


A total of 285 urine samples were collected from 285 patients for analysis. An almost equal gender distribution was achieved. Out of the 285 patients included, 163 were outpatient, 104 were inpatient, 14 were wards in the ICU, and 4 presented to the emergency department). In total, 140 of 285 samples (49%) yielded ≥ 103 CFU/ml bacterial growth (73 with Gram-negative bacteria, 36 with Gram-positive bacteria, 27 with mixed cultures, and 4 with yeast). In comparison, 68 samples (23.9%) yielded ≥ 105 CFU/ml bacterial growth on urine cultures. We found that a UF-5000 bacterial count of ≥ 590.3 /uL predicted ≥ 105 CFU/ml bacterial growth on urine culture with a sensitivity of 86.8% and specificity of 81.1%. The bacterial discrimination performance of the UF-5000 for GN bacteria was superior to that for GP bacteria.


UF-5000 demonstrated a good potential utility for rapid UTI screening. The instrument’s ability to predict Gram-negative bacterial infection is reasonable despite the need for further evaluation.


  • Commercial Support – Sysmex(Thailand) Co.,Ltd.