Age-Specific Cutoffs of the Sysmex UF-1000i Automated Urine Analyzer for Rapid Screening of Urinary Tract Infections in Outpatients

We investigated the usefulness of age-specific cutoffs for screening of urinary tract infections (UTIs) in Korean outpatients, using the automated urine analyzer UF-1000i (Sysmex, Kobe, Japan). We retrospectively reviewed outpatient medical records. Urine samples of 7,443 outpatients from January 2010 to December 2017 were analyzed using urine culture and UF-1000i. ROC curves were calculated for each UF-1000i parameter based on the culture results. There were 1,398 culture positive samples, 5,774 culture negative samples, and 271 contaminated samples. UF-1000i had an area under the curve of ≥0.9 in outpatients >15 years. The appropriate cutoffs, which are the sum of bacterial (B-A-C) and white blood cell (WBC) counts, were 297.10/µL (15–24 years), 395.65/µL (25–44 years), 135.65/µL (45–64 years), 67.95/µL (65–74 years), and 96.5/µL (≥75 years). B-A-C and WBC counts differed among the three most frequently identified bacteria (Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis). The UF-1000i system is useful for applying age-specific cutoffs to screen for UTIs, thereby preventing antibiotic abuse and reducing antibiotic resistance. Future studies can explore how its B-A-C and WBC counts can facilitate selection of empirical antibiotics by distinguishing between gram-positive and gram-negative bacteria.

Comparison of YD URiSCAN PluScope Urine Microscopic Analyzer and Sysmex UF-1000i Flow Cytometry Systems

BACKGROUND: Urinalysis is one of the most commonly performed tests in clinical laboratories. In this study, we compared YD URiSCAN PluScope (PluScope; YD Diagnostics Corp., Korea) and Sysmex UF-1000i (UF-1000i; Sysmex Corp., Japan) for urine microscopic sediment analysis. METHODS: A total of 404 fresh urine samples were collected and analyzed using PluScope, UF-1000i, and manual microscopy. Quantitative correlation analyses for red blood cells (RBCs), white blood cells (WBCs), epithelial cells (EC), and casts were performed using Spearman's correlation. We evaluated agreement among the three systems by using weighted Cohen's κ and calculating concordance rates within one grade of difference for semiquantitative and qualitative parameters. RESULTS: There were moderate-high correlations between PluScope and UF-1000i for RBCs, WBCs, and ECs (r=0.542, 0.714, and 0.571, respectively) but negligible correlation for casts (r=0.186). There were moderate-high correlations between manual microscopy and automated devices for RBCs, WBCs, and ECs (r=0.550–0.745) but negligible correlations for casts (PluScope: r=0.247; UF-1000i: r=0.223). The pairwise concordance rates within one grade difference among the three methods were good for RBCs, WBCs, and ECs (95.0%–99.0%, κ=0.41–0.74). For casts, the concordance rate between PluScope and manual microscopy was fair (96.8%, κ=0.25), but concordance rates between UF-1000i and manual microscopy and between the two automated devices were poor (81.2% and 81.7%; κ=0.04 and 0.06, respectively). CONCLUSIONS: The two automated urine sediment analyzers showed a moderate-high correlation and concordance rate. They showed good correlations and concordance rates for RBCs, WBCs, and ECs. However, manual microscopic examinations are still needed for reviewing and confirming the presence of pathologic particles in urine, such as casts and crystals.

Value of Sysmex UF-1000i Urinary Sediment Analyzer in Diagnosis of Urinary Tract Infection due to Different Urinary Specimen Collection Methods / 医学研究杂志

Objective To explore the value of Sysmex UF-1000i urinary sediment analyzer in diagnosis of urinary tract infection (UTI) and clarify the influence caused by different specimen on UF-1000i diagnosing UTI.Methods Totally 466 specimens examined bacterial culture and routine urinalysis were collected from patients suspected of UTI during July and August,2015 (samples of group A).148 specimens during late March and early April were gathered to implement a urine culture and then the rest of urine were detected byUF -1000i urinary sediment analyzer instantly(samples of group B).Bacteria and leukocyte counts were gathered and then receiver operating characteristic (ROC) carve was drawn regarding thegold standard as bacterial culture by SPSS18.0.Next,the threshold values of bacteria and leukocyte counts for diagnosis of UTI were found out.Meanwhile,itssensitivity,specificity,positive/negative predictive value,false positive/false negative value,and diagnostic accuracy were calculated.Results The cut off values to samples of group A were101.7 bacteria/μl and 18.8WBC/μl respectively and to samples of group B were 98.7 bacteria/μl and 11.1WBC/μl respectively.The area of Bacteria and leukocyte counts under ROC carve was 0.604 and 0.661 to samples of group A and 0.941 and 0.848 to samples Of group B.To samples of group B,combined Bacteria and leukocyte counts for UTI,the optimum sensitivity was 82.4％,specificity was 92.1％,positive predictive value was 77.8％,negative predictive value was 93.8％,false positive rate was 7.9％,false negative rate was 17.6％,and accuracy was 89.9％.Bacterial culture was reduced by 70.9％.Conclusion UF-1000i urine sediment analyzers have the value of early screening value and help to diagnose UTI.Urine that was sterilely collected and examined within two hours can make the value of UF-1000i maximized.

Compare the value of UF-1000i urinary sediment analyzer and phase-contrast microscopy in distinguishing source of hematuresis / 国际检验医学杂志

Objective To compare the value of UF‐1000i urinary sediment analyzer and phase‐contrast microscopy in identify source of hematuria .Methods A total of 98 patients diagnosed as hematuresis from December 2013 to May 2014 in the Affiliated Hospital of Putian Institute were enrolled in this study .Both the urinary sediment examination and phase‐contrast microscopy ex‐amination were conducted on the patients .According to clinical diagnosis results ,the sensitivity and specificity of the two methods were calculated and compared .Results The sensitivity of UF‐1000i urinary sediment analyzer (95 .3% ) was higher than that of the phase contrast microscope (81 .9% ) ,the difference was significant (P < 0 .05) ,while the specificity of phase contrast microscope (92 .3% ) was higher than that of UF‐1000i urinary sediment analyzer(89 .2% ) ,the difference was significant(P < 0 .05) .Conclu‐sion Combining application of UF‐1000i urinary sediment analyzer and phase contrast microscope has great clinical significance .

Evaluation of an Automated Urine Flow Cytometer for Screening of Bacterial Contamination in Platelet Concentrates

BACKGROUND: Bacterial contamination of blood products, particularly of platelet concentrates (PCs), is a major risk factor for infections caused by blood transfusion. Various methods for the detection of bacterial contamination in PCs are available or are under investigation. We evaluated the usefulness of the Sysmex UF-1000i urine flow cytometer (Sysmex Medical Electronics Co, Japan) for screening of bacterial contamination in PCs. METHODS: The PCs were inoculated with various concentrations of bacteria (Staphylococcus aureus and Escherichia coli) and were analyzed with the urine flow cytometer for bacterial counts. All the samples were diluted with normal saline (1:10) before flow cytometric analysis in order to prevent interference by the turbidity due to platelets. RESULTS: For PCs inoculated with a high number (colony forming unit, CFU) of bacteria (105 CFU/mL), the bacterial counts were significantly higher than those for uninoculated PCs analyzed by the urine flow cytometer. However, bacterial counts for PCs inoculated with bacteria of 104 CFU/mL or less and those for uninoculated PCs were not significantly different. CONCLUSIONS: An automated urine flow cytometer evaluated in this study is easy to use, and the procedure is completed in less than 5 min. Moreover, the urine flow cytometer could detect approximately 105 CFU/mL of bacteria in PCs. Further validation studies are needed to assess the usefulness of this method for screening of bacterial contamination in PCs.