Urine-blood culture concordance in suspected urosepsis and implications for early clinical decision-making
4 affiliations
- 1Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
- 2Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Medical University of Innsbruck, Innsbruck, Austria
- 3Health Data Competence Center, Tirol Kliniken GmbH, Innsbruck, Austria
- 4Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria; Corresponding author.
Abstract
Objectives: To assess microbiological concordance, antimicrobial susceptibility testing (AST) agreement, and associated clinical characteristics of suspected urosepsis episodes using paired urine (UC) and blood cultures (BC). Methods: We retrospectively analyzed 2572 paired UC-BC episodes from 2302 adults at a tertiary-care laboratory (2018-2024). Episodes were considered concordant when UC and BC shared at least one identical pathogen. We compared pathogen spectra, culture dynamics, AST results, laboratory referral information, inflammatory markers, and survival. Multivariable logistic regression was used to identify factors associated with concordance. Results: Of 2572 episodes, 1405 (54.6%) were concordant. UC reports were finalized earlier than BC reports, with 50.4% available within 1 day. Concordant episodes showed shorter BC time-to-positivity than discordant episodes (7.8 vs 14.1 hours). Documented clinical suspicion and detection of Escherichia coli or Staphylococcus aureus in UC were associated with concordance. Among concordant Enterobacterales episodes, UC AST showed high agreement with BC AST. In exploratory analyses, concordant episodes were associated with faster decline of inflammatory markers and better survival. Conclusions: In suspected urosepsis, UC frequently identified the same pathogen as BC while providing earlier microbiological and susceptibility information. These findings support the potential early diagnostic and antimicrobial stewardship value of UC while BC results remain pending.
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BibTeX
@article{grubwieser2026urineblood,
title = {{Urine-blood culture concordance in suspected urosepsis and implications for early clinical decision-making}},
author = {Philipp Grubwieser and Silke Huber and Angelika Bauer and Wolfram Mayr and Werner O. Hackl and Cornelia Lass-Flörl and Werner Ruppitsch and Miriam Alisa Govrins},
journal = {International Journal of Infectious Diseases},
year = {2026},
month = oct,
doi = {10.1016/j.ijid.2026.109092},
url = {https://doi.org/10.1016/j.ijid.2026.109092},
note = {CC BY},
}
RIS
TY - JOUR
TI - Urine-blood culture concordance in suspected urosepsis and implications for early clinical decision-making
AU - Philipp Grubwieser
AU - Silke Huber
AU - Angelika Bauer
AU - Wolfram Mayr
AU - Werner O. Hackl
AU - Cornelia Lass-Flörl
AU - Werner Ruppitsch
AU - Miriam Alisa Govrins
PY - 2026
DA - 2026/10/30
JO - International Journal of Infectious Diseases
DO - 10.1016/j.ijid.2026.109092
UR - https://doi.org/10.1016/j.ijid.2026.109092
AB - Objectives: To assess microbiological concordance, antimicrobial susceptibility testing (AST) agreement, and associated clinical characteristics of suspected urosepsis episodes using paired urine (UC) and blood cultures (BC). Methods: We retrospectively analyzed 2572 paired UC-BC episodes from 2302 adults at a tertiary-care laboratory (2018-2024). Episodes were considered concordant when UC and BC shared at least one identical pathogen. We compared pathogen spectra, culture dynamics, AST results, laboratory referral information, inflammatory markers, and survival. Multivariable logistic regression was used to identify factors associated with concordance. Results: Of 2572 episodes, 1405 (54.6%) were concordant. UC reports were finalized earlier than BC reports, with 50.4% available within 1 day. Concordant episodes showed shorter BC time-to-positivity than discordant episodes (7.8 vs 14.1 hours). Documented clinical suspicion and detection of Escherichia coli or Staphylococcus aureus in UC were associated with concordance. Among concordant Enterobacterales episodes, UC AST showed high agreement with BC AST. In exploratory analyses, concordant episodes were associated with faster decline of inflammatory markers and better survival. Conclusions: In suspected urosepsis, UC frequently identified the same pathogen as BC while providing earlier microbiological and susceptibility information. These findings support the potential early diagnostic and antimicrobial stewardship value of UC while BC results remain pending.
SN - 1201-9712
SN - 1878-3511
ER -