Multiplex Pathogen Identification for Polymicrobial Urinary Tract Infections Using Biosensor Technology: A Prospective Clinical Study
2009; Lippincott Williams & Wilkins; Volume: 182; Issue: 6 Linguagem: Inglês
10.1016/j.juro.2009.08.028
ISSN1527-3792
AutoresKathleen E. Mach, Christine B Du, Hardeep Phull, David A. Haake, Mei-Chiung Shih, Ellen Jo Baron, Joseph C. Liao,
Tópico(s)Gut microbiota and health
ResumoNo AccessJournal of UrologyAdult Urology1 Dec 2009Multiplex Pathogen Identification for Polymicrobial Urinary Tract Infections Using Biosensor Technology: A Prospective Clinical Study Kathleen E. Mach, Christine B. Du, Hardeep Phull, David A. Haake, Mei-Chiung Shih, Ellen Jo Baron, and Joseph C. Liao Kathleen E. MachKathleen E. Mach , Christine B. DuChristine B. Du , Hardeep PhullHardeep Phull , David A. HaakeDavid A. Haake , Mei-Chiung ShihMei-Chiung Shih , Ellen Jo BaronEllen Jo Baron , and Joseph C. LiaoJoseph C. Liao View All Author Informationhttps://doi.org/10.1016/j.juro.2009.08.028AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Rapid diagnosis of urinary tract infection would have a significant beneficial impact on clinical management, particularly in patients with structural or functional urinary tract abnormalities who are highly susceptible to recurrent polymicrobial infections. We examined the analytical validity of an electrochemical biosensor array for rapid molecular diagnosis of urinary tract infection in a prospective clinical study in patients with neurogenic bladder. Materials and Methods: The electrochemical biosensor array was functionalized with DNA probes against 16S rRNA of the most common uropathogens. Spinal cord injured patients at a Veterans Affairs hospital were recruited into the study. Urine samples were generally tested on the biosensor within 1 to 2 hours of collection. Biosensor results were compared with those obtained using standard clinical microbiology laboratory methods. Results: We successfully developed a 1-hour biosensor assay for multiplex identification of pathogens. From July 2007 to December 2008 we recruited 116 patients, yielding a total of 109 urine samples suitable for analysis and comparison between biosensor assay and standard urine culture. Of the samples 74% were positive, of which 42% were polymicrobial. We identified 20 organisms, of which Escherichia coli, Pseudomonas aeruginosa and Enterococcus species were the most common. Biosensor assay specificity and positive predictive value were 100%. Pathogen detection sensitivity was 89%, yielding a 76% negative predictive value. Conclusions: To our knowledge we report the first prospective clinical study to successfully identify pathogens within a point of care time frame using an electrochemical biosensor platform. Additional efforts to improve the limit of detection and probe design are needed to further enhance assay sensitivity. References 1 : Urologic Diseases in America project: trends in resource use for urinary tract infections in men. J Urol2005; 173: 1288. Link, Google Scholar 2 : Urologic Diseases in America project: trends in resource use for urinary tract infections in women. J Urol2005; 173: 1281. Link, Google Scholar 3 : Urinary tract infections in patients with spinal cord lesions: treatment and prevention. Drugs2001; 61: 1275. Google Scholar 4 : Etiology and incidence of rehospitalization after traumatic spinal cord injury: a multicenter analysis. Arch Phys Med Rehabil2004; 85: 1757. Google Scholar 5 : Epidemiology and risk factors for urinary tract infection in patients with spinal cord injury. J Urol2000; 164: 1285. Google Scholar 6 : Use of electrochemical DNA biosensors for rapid molecular identification of uropathogens in clinical urine specimens. J Clin Microbiol2006; 44: 561. Google Scholar 7 : Development of an advanced electrochemical DNA biosensor for bacterial pathogen detection. J Mol Diagn2007; 9: 158. Google Scholar 8 : High prevalence of nosocomial infections in rehabilitation units accounted for by urinary tract infections in patients with spinal cord injury. J Hosp Infect2006; 62: 473. Google Scholar 9 : Increasing resistance against antibiotics in bacteria isolated from the lower urinary tract of an outpatient population of spinal cord injury patients. Urol Int2004; 73: 143. Google Scholar 10 : Practical bench comparison of BBL CHROMagar Orientation and standard two-plate media for urine cultures. J Clin Microbiol2004; 42: 60. Google Scholar 11 : Evaluation of BBL CHROMagar orientation medium for detection and presumptive identification of urinary tract pathogens. J Clin Microbiol1997; 35: 2773. Google Scholar 12 : The application of biofilm science to the study and control of chronic bacterial infections. J Clin Invest2003; 112: 1466. Google Scholar 13 : Outsourcing microbiology and offsite laboratories: Implications on patient care, cost savings, and graduate medical education. Arch Pathol Lab Med2003; 127: 623. Google Scholar 14 Mai JDH, Gaster RS, Wu A et al: A microfluidic system for rapid bacterial pathogen detection. Presented at IEEE International Conference on Nanotechnology, Hong Kong Special Administrative Region of People's Republic of China, August 2–5, 2007, p 1330. Google Scholar Departments of Urology, Health Research and Policy and Pathology, Stanford University School of Medicine, Stanford, Veterans Affairs Palo Alto Health Care System, Palo Alto and Department of Medicine, David Geffen School of Medicine at University of California-Los Angeles and Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California© 2009 by American Urological AssociationFiguresReferencesRelatedDetailsCited byAtala A (2014) Re: Enhanced Susceptibility to Urinary Tract Infection in the Spinal Cord-Injured Host with Neurogenic BladderJournal of Urology, VOL. 191, NO. 5, (1470-1471), Online publication date: 1-May-2014.Mach K, Mohan R, Baron E, Shih M, Gau V, Wong P and Liao J (2010) A Biosensor Platform for Rapid Antimicrobial Susceptibility Testing Directly From Clinical SamplesJournal of Urology, VOL. 185, NO. 1, (148-153), Online publication date: 1-Jan-2011. Volume 182Issue 6December 2009Page: 2735-2741 Advertisement Copyright & Permissions© 2009 by American Urological AssociationKeywordsRNAurinary bladderbiosensing techniques16Surinary tract infectionsribosomalneurogenicspinal cord injuriesAcknowledgmentsVictoria Wolfe, Christina Hirsch and Mey Yip, SCI Unit, Veterans Affairs Palo Alto Health Care System, assisted with urine collection; Simon Kimm assisted with figure 1; Vincent Gau provided technical support; 33% of urine samples were analyzed at Specialty Laboratories, Valencia, California; and oligonucleotide probes were synthesized at IDT, Coralville, Iowa.MetricsAuthor Information Kathleen E. Mach More articles by this author Christine B. Du More articles by this author Hardeep Phull More articles by this author David A. Haake More articles by this author Mei-Chiung Shih More articles by this author Ellen Jo Baron Financial interest and/or other relationship with Cepheid, OpGen, Key Scientific, AHT Mediq, bioMerieux, MicroPhage and Merck. More articles by this author Joseph C. Liao More articles by this author Expand All Advertisement PDF downloadLoading ...
Referência(s)