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Abstract

Abstract Title

Diagnostic accuracy and antibiotic stewardship: evaluating automated urinalysis in urinary tract infection management

Presentation Type

Moderated Poster Abstract

Manuscript Type

Clinical Research

Abstract Category *

Infectious Disease / Urologic Trauma

Author's Information

Number of Authors (including submitting/presenting author) *

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Please ensure the authors are listed in the right order.

Co-author 1

Ruofan Shi shirf@hku.hk The University of Hong Kong Department of Surgery Hong Kong Hong Kong, China -

Co-author 2

Tsun Tsun Stacia Chun stac@hku.hk The University of Hong Kong Department of Surgery Hong Kong Hong Kong, China -

Co-author 3

Rong Na yungna@hku.hk The University of Hong Kong Department of Surgery Hong Kong Hong Kong, China *

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Abstract Content

Introduction

This is a prospective randomized clinical trial evaluating the reduce of unnecessary antibiotic use in patients with urinary tract infection (UTI)-like symptoms based on the rapid automated urinalysis of UF-5000 from Sysmex Co., Japan.

Materials and Methods

A total of 78 patients with UTI-like symptoms (lower urinary tract symptoms, hematuria, etc.) were enrolled between Mar 2024 and Mar 2025 at Queen Mary Hospital in Hong Kong. Midstream urine samples were collected for automated urinalysis which provide rapid test (~10min) for UTI status and Gram staining results. Urine culture was subsequently sent for validation. The control group received immediate empirical antibiotics and the intervention group was prescribed antibiotics primarily based on urinalysis results.

Results

60.3% of the participants were female. Based on the block randomization, 47 and 31 patients were randomized to the empirical and intervention group respectively. Automated urinalysis-reported UTI demonstrated a sensitivity of 92.9% and specificity of 44.4% compared to urine culture. For patients whose urinalysis did not indicate UTI in the intervention group, a delay of antibiotics treatment will be provided. Among them, 88.2% had negative urine cultures, and 68.2% unnecessary empirical antibiotic use was avoided. The remaining 11.8% patients (n=2) did not report any unexpected adverse events (≥Grade 2) with the delayed antibiotics treatment.

Conclusions

Sysmex UF-5000 urinalysis system provides rapid evaluation of UTI status and Gram staining results. A significant reducing of unnecessary antibiotic use was observed in the intervention group (delayed antibiotics treatment) without unexpected adverse events.

Keywords

Automated urinalysis; urinary tract infections (UTIs); antibiotic stewardship; diagnostic accuracy; randomized clinical trial.

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Presentation Order