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Peer-reviewedCC BY 4.0Infection

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

  • B. Dirk1,2
  • T. Hwandih3
  • M. Holz1
  • B. Schönbeck3
  • L. von Müller1,2
  1. 1Christophorus Kliniken GmbH, Südring 10, 48653 Coesfeld, Germany
  2. 2Faculty of Medicine, Saarland University, Homburg, Germany
  3. 3Sysmex Europe SE, Hamburg, Germany
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Abstract

Purpose: We compared urine dipstick testing (DS) with quantitative flow cytometry (FC) and evaluated a diagnostic algorithm to optimise urinary tract infection (UTI) screening.

Methods: 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.

Results: 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).

Conclusion: 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.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02920-w.

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Cite

BibTeXRIS
BibTeX
@article{dirk2026rapid,
  title = {{Rapid screening of urinary tract infections: quantitative flow cytometry versus dipstick testing in a hospital cohort}},
  author = {B. Dirk and T. Hwandih and M. Holz and B. Schönbeck and L. von Müller},
  journal = {Infection},
  year = {2026},
  month = aug,
  doi = {10.1007/s15010-026-02920-w},
  url = {https://doi.org/10.1007/s15010-026-02920-w},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Rapid screening of urinary tract infections: quantitative flow cytometry versus dipstick testing in a hospital cohort
AU  - B. Dirk
AU  - T. Hwandih
AU  - M. Holz
AU  - B. Schönbeck
AU  - L. von Müller
PY  - 2026
DA  - 2026/08/11
JO  - Infection
DO  - 10.1007/s15010-026-02920-w
UR  - https://doi.org/10.1007/s15010-026-02920-w
AB  - Purpose: We compared urine dipstick testing (DS) with quantitative flow cytometry (FC) and evaluated a diagnostic algorithm to optimise urinary tract infection (UTI) screening.  Methods: 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.  Results: 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).  Conclusion: 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.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02920-w.
SN  - 0300-8126
SN  - 1439-0973
ER  -