Clinical Usefulness of Early Evaluation of the Bacteriological Effect of Antibiotics Administered as Empiric Therapy Using the Fully Automated Urine Particle Analyzer UF-5000 in Febrile Urinary Tract Infections

利用全自动尿液颗粒分析仪UF-5000对发热性尿路感染患者进行经验性抗生素治疗的早期细菌学疗效评估的临床应用价值

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Abstract

OBJECTIVES: Antimicrobial susceptibility test results following urine cultures over 3 days indicate that clinical symptoms and overall patient condition should be closely monitored to ascertain the effectiveness of a specific antibiotic course. A Fully Automated Urine Particle Analyzer UF-5000 (UF-5000) was used to detect bacteria in the urine. This study evaluated whether clinical urine samples could be analyzed using UF-5000 for rapid assessment of empiric antibiotic efficacy in treating febrile urinary tract infection. METHODS: The optimal exposure time to antibiotics was estimated to determine the susceptibility of bacterial strains in an in vitro culture system using the UF-5000. To determine the optimal timing for rapid evaluation of the efficacy of empiric antibiotics in patients with febrile urinary tract infection, the bacterial number and morphological changes in the urine were examined over time using the UF-5000 and compared with Gram staining results. RESULTS: In vitro experiments showed that the optimal conditions for monitoring the bacterial count on the BACT scattergram of the UF-5000 were 6 h after antibiotic administration. In 10 clinical cases, empiric antibiotics generally showed good susceptibility to the dominant pathogen, and the BACT scattergram showed a significant decrease in bacterial counts after 6 h, but bacterial counts increased 24 h after antibiotic administration in three cases; in two cases, the antimicrobial treatment effects were inadequate based on clinical assessment, and in other cases, patients had to undergo multiple treatments. CONCLUSION: Monitoring bacterial counts during empiric antibiotic therapy using the UF-5000 can help predict the effectiveness of antimicrobial treatment.

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