Introduction
death, urinary tract infections, bacterial infection, infections, bacteriuria, sepsis, UTIs
INFECTIOUS DISEASES, SYSTEMIC DISEASE, URINARY TRACT INFECTIONS, URINARY TRACT INFECTIONS, BACTERIAL INFECTION, INFECTIONS, NOSOCOMIAL INFECTIONS, UTI, SEPSIS
Urinary tract infections (UTIs) are among the most prevalent infectious diseases in both community and healthcare settings [Among hospital settings, UTIs account for almost 40% of all nosocomial infections, and represent a major burden, given the associated morbidity and mortality. A correlation between urinary tract infections and systemic diseases has been recently suggested as patients displaying bacteriuria due to drug-resistant pathogens are more prone to develop sepsis, often due to treatment failure [The emergence of antimicrobial resistance (AMR) is a major public health challenge that is threatening the effective prevention and treatment of an ever-increasing range of infections. Mortality rates associated to drug-resistant microorganisms are expected to rise in the next decades. As stated by the National Institute for Health and Care Excellence (NICE), by 30 years up to 10 million people could be under death threat due to unsuccessful antibiotic treatment [Uropathogens vary from the community to the hospital setting, with different main agents prevailing and higher AMR frequencies in the latter; this causes a greater difficulty to achieve successful treatment, associated with longer hospitalization, patient’s uneasiness and overall higher costs [Suspected UTIs are commonly treated with antibiotics, and guidelines recommend starting an empirical treatment before the results of urine culture and AST are available [In this context, the importance of using evidence-based strategies for the treatment of UTI becomes undeniable: a fast and accurate diagnosis, leading to a rational treatment, is in fact essential to provide a timely and successful therapy.The National Institute of Clinical Excellence has long been demanding the improvement and implementation of urine testing seeking for markers of bacterial infection in order to avoid empiric treatment for suspected UTIs [In this context, Point of care Tests (POCTs) for UTI diagnosis, where testing is provided close to or near the patient, are currently being studied; their implementation in routine practice could facilitate the screening of UTIs, allow prompt treatment only when needed, and ultimately optimize workflows in order to reduce the burden on central laboratories, allow adherence to guidelines and improve therapeutical outcomes [In a previous paper we described a new POCT for UTI detection upon culture of urine samples based on the Micro Biological Survey method. This POCT demonstrated to be accurate and time saving: performed in ready to use, disposable reaction vials and based on the time taken for the reaction vials to change color. It allows a quantitative assessment in of viable bacteria concentration in urine samples in less than 5 hours, not needing other instrumentation than a dedicated thermostatic reader which automatically provides results, opening for automation and processing of multiple samples [Here, the proficiency of the MBS AST-POCT was tested in two trials conducted between 2015 and 2017 in two clinical Departments differing in demographic and clinical profile of cared patients, in order to achieve a broader and realistic assessment of the performances of the AST-POCT in both community and hospital settings.