Ann Clin Microbiol.  2021 Sep;24(3):83-96. 10.5145/ACM.2021.24.3.3.

Evaluation of Five Automated Urine Analyzers as Screening Instruments for Enhancing Diagnostic Efficiency in Urinary Tract Infection

  • 1Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • 2Department of Laboratory Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 3Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
  • 4Department of Laboratory Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
  • 5Department of Laboratory Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea


Although urine culture is considered a reference standard for the diagnosis of urinary tract infection (UTI), it is time-consuming, labor-intensive, and expensive. Here, we evaluated the performance of five recent automated urine analyzers for UTI diagnosis.
For the 510 specimens analyzed, the criterion for ‘significant bacteriuria’ was defined as ≥ 104 CFU/mL in the inoculated plate for all specimens or ≥ 103 CFU/mL for specimens from patients using a Foley catheter or with urinary symptoms. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of UTI were analyzed using indicators individually, in different combinations, or with various cut-off values.
Seventy-one specimens (13.9%) exhibited ‘significant bacteriuria’. In the eceiver operating characteristics curve analysis, UF-5000 (Sysmex Corp., Japan) showed the highest area under the curve values for both males and females (0.876 and 0.846, respectively). The PPVs for specimens from males with all indicators positive increased up to 100% after adjusting the cut-off values. NPVs for specimens with all indicators negative were 94.3%– 98.2% in males and 78.1%–93.8% in females after adjusting the cut-off values.
As a rapid and accurate diagnostic tool, urine sediment analyzers can be valuable for UTI diagnosis by reducing unnecessary culture and can help clinicians determine a treatment plan.


Automated urine analyzer; Screening test; Urine culture; , Urinary tract infections
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