Abstract
Urinary tract infections (UTIs) pose a significant challenge to human health. Accurate and timely detection remains pivotal for effective intervention. Current urine culture techniques, while essential, often encounter challenges where urinalysis yields positive results, but subsequent culture testing produces a negative result. This highlights potential discrepancies between the two methods and emphasizes the need for improved correlation in urinary tract infection (UTI) detection. Employing advanced lipidomics techniques, we deployed the fast lipid analysis technique (FLAT) on a clinical cohort suspected of having UTIs. Lipid fingerprinting by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), directly from urine samples without ex vivo growth, correctly identified the common uropathogens within a 1 hour timeframe when compared to urine culture. FLAT analysis also identified urine samples without culturable pathogens (negative UTIs) with 99% microbial identification (ID) agreement, whereas urinalysis showed 37% ID agreement with the gold standard urine culture. In 402 urine samples suspected for UTI from outpatients, FLAT assay rapidly ruled out negative urines without the need for culture in 77% of all cases. The potential impact of this innovative lipidomic-based approach extends beyond conventional diagnostic limitations, offering new avenues for early detection and targeted management of urinary tract infections. This research marks a paradigm shift in urine culture methodology, paving the way for improved clinical outcomes and public health interventions. IMPORTANCE: This study employs a lipidomics-based method that promises to enhance the accuracy and reliability of urine culture diagnostics within 1 hour of sample collection. Our findings underscore the potential of lipidomics as a valuable tool in identifying and characterizing microbial populations present in urine samples and efficiently rule out negative urines, ultimately leading to improved patient care and management of urinary tract infections.