Bacterial Distribution Pattern of Urine in Men With Gonococcal Urethritis

Abstract

Background: Rapid screening for agents of urethritis is imperative to determine proper antibiotic treatment while waiting for the culture and sensitivity tests. This study evaluated the performance of Sysmex UF500i urine analyzer in identifying possible pathogens using the pattern produced by bacterial scatter plot.

Methods: A total of 194 walk-in male patients came to the laboratory for urinalysis and culture of genitourinary specimens. Specimens were analyzed for routine urinalysis and bacteriological culture utilizing both manual and automated procedures. Sysmex UF500i instrument was used for counting cells per µL taking into account the bacterial scatterplot produced, while isolated organisms were identified using Vitek Compact 2.

Results: Out of these 194 specimens, 106 (54.63%) were from patients with obvious manifestations of urethritis. From these 106 specimens, 97 (91.5%) were found to contain Neisseria gonorrhoeae (N. gonorrhoeae) by culture results and nine (8.49%) indicated other pathogens. A total of 96 out of 97 specimens illustrated a bacterial distribution in the scatter plot that is below 10°, having a concordance rate of 98.97%. Additionally, bacterial distribution patterns of below 10° or those that contain N. gonorrhoeae were still noted among specimens with low numbers of white blood cells (as low as 11 cells/µL) and low bacterial counts (as low as 9.1 cells/µL).

Conclusions: The UF500i urine analyzer is a valuable method to screen urine specimens containing N. gonorrhoeae utilizing the bacterial scatter plot, and may contribute to faster administration of antibiotics while waiting for the culture results.

Clin Infect Immun. 2020;5(2):31-38
doi: https://doi.org/10.14740/cii99