ArticleJournal of clinical microbiology2019
Reassessment of Routine Midstream Culture in Diagnosis of Urinary Tract Infection.
Article in Journal of clinical microbiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers.
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Who cites it
40 citing papers in PubMed.
- Effect of human urinary microenvironment and fluid flow on antibiotic and phage therapy efficacy against uropathogenic Escherichia coli.Nature communications · 2026Article
- Reducing culture underestimation in urine: flow cytometry-guided validation of low-dose DTT pre-treatment for biofilm dispersal.Microbiology spectrum · 2026Article
- Differential antimicrobial responses in polymicrobial triple-species biofilms associated with persistent urinary tract infections.Scientific reports · 2026Article
- Rethinking urinary tract infections in women with abdominal pain in pregnancy: a prospective case-control study.BMC pregnancy and childbirth · 2026Observational
- Analytical validation of a metagenomic next-generation diagnostic platform for urinary tract infection in a Thai tertiary hospital setting: a BI-Biotia UTI cohort study.Frontiers in cellular and infection microbiology · 2026Article
- The natural immune molecules urinary Tamm-Horsfall protein and pentraxin 3 as predictors for recurrent urinary tract infection severity: a single-center self-control study.Renal failure · 2025Article
- Antibiogram pattern of recurrent urinary tract infections in kidney transplant patients: a single-center cohort study.Clinical transplantation and research · 2025Article
- Prevalence of Urine Culture Contamination in a Primary Care Outpatient Setting in Muscat, Oman:Sultan Qaboos University medical journal · 2025Article
- 16S rRNA Gene Sequence Analysis of V6-V8 Region Provides Limited Advantage in Diagnosis of Chronic Prostatitis.Diagnostics (Basel, Switzerland) · 2025Article
- Novel Techniques to Unravel Causative Bacterial Ecological Shifts in Chronic Urinary Tract Infection.Pathogens (Basel, Switzerland) · 2025Article
- Rapid and accurate testing for urinary tract infection: new clothes for the emperor.Clinical microbiology reviews · 2025Review
- A highly accurate nanopore-based sequencing workflow for culture and PCR-free microbial metagenomic profiling of urogenital samples.BMC urology · 2025Article
- Novel technologies for the diagnosis of urinary tract infections.Journal of clinical microbiology · 2025Review
- A lipidomics-based method to eliminate negative urine culture in general population.Journal of clinical microbiology · 2024Article
- Enhancing Pathogen Detection in Implant-Related Infections through Chemical Antibiofilm Strategies: A Comprehensive Review.Antibiotics (Basel, Switzerland) · 2024Review
- Pathogen non-planktonic phases within the urinary tract impact early infection and resistance evolution.The ISME journal · 2024Article
- From Awareness to Action: Pioneering Solutions for Women's UTI Challenges in the Era of Precision Medicine.International journal of women's health · 2024Article
- A human urothelial microtissue model reveals shared colonization and survival strategies between uropathogens and commensals.Science advances · 2023Article
- Improving Patient Outcomes While Reducing Empirical Treatment with Multiplex-Polymerase-Chain-Reaction/Pooled-Antibiotic-Susceptibility-Testing Assay for Complicated and Recurrent Urinary Tract Infections.Diagnostics (Basel, Switzerland) · 2023Article
- Mixed Bacterial Growth in Prenatal Urine Cultures; An Investigation into Prevalence, Contributory Factors and the Impact of education-based Interventions.Maternal and child health journal · 2023Observational
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Midstream urine (MSU) culture remains the gold standard diagnostic test for confirming urinary tract infection (UTI). We previously showed that patients with chronic lower urinary tract symptoms (LUTS) below the diagnostic cutoff on MSU culture may still harbor bacterial infection and that their antibiotic treatment was associated with symptom resolution. Here, we evaluated the results of the United Kingdom's MSU culture in symptomatic patients and controls. Next, we compared the bacterial enrichment capabilities of the MSU culture with those of a 50-µl uncentrifuged culture, a 30-ml centrifuged sediment culture, and 16S rRNA gene sequencing. This study was conducted on urine specimens from 33 LUTS patients attending their first clinical appointment (mean age, 48.7 years; standard deviation [SD], 16.5 years), 30 LUTS patients on treatment (mean age, 47.8 years; SD, 16.5 years) whose symptoms had relapsed, and 29 asymptomatic controls (mean age, 40.7 years, SD, 15.7 years). We showed that the routine MSU culture, adopting the UK interpretation criteria tailored to acute UTI, failed to detect a variety of bacterial species, including recognized uropathogens. Moreover, the diagnostic MSU culture was unable to discriminate between patients and controls. In contrast, genomic analysis of urine enriched by centrifugation discriminated between the groups, generating a more accurate understanding of species richness. In conclusion, the United Kingdom's MSU protocol misses a significant proportion of bacteria, which include recognized uropathogens, and may be unsuitable for excluding UTI in patients with LUTS.
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