In house-development of a rapid immunochromatographic test for the detection of Escherichia coli in urine samples

Paula Da Cunda; Amy Mónaco; María Moreno; María José Gonzalez; Paola Scavone; Luciana Robino

doi:10.1016/j.ram.2023.10.001

In house-development of a rapid immunochromatographic test for the detection of Escherichia coli in urine samples

Rev Argent Microbiol. 2023 Dec 8:S0325-7541(23)00084-6. doi: 10.1016/j.ram.2023.10.001. Online ahead of print.

Authors

Paula Da Cunda¹, Amy Mónaco², María Moreno², María José Gonzalez³, Paola Scavone³, Luciana Robino⁴

Affiliations

¹ Departamento de Bacteriología y Virología, Instituto de Higiene, Facultad de Medicina, Universidad de la República, Uruguay.
² Departamento de Desarrollo Biotecnológico, Instituto de Higiene, Facultad de Medicina, Universidad de la República, Uruguay.
³ Laboratorio de Biofilms Microbianos, Departamento de Microbiología, Instituto de Investigaciones Biológicas Clemente Estable, Ministerio de Educación y Cultura, Uruguay.
⁴ Departamento de Bacteriología y Virología, Instituto de Higiene, Facultad de Medicina, Universidad de la República, Uruguay. Electronic address: lrobino@higiene.edu.uy.

PMID: 38071171
DOI: 10.1016/j.ram.2023.10.001

Abstract

Urinary tract infections (UTIs) are a common health concern. Urine culture is the "gold standard" for UTI diagnosis but takes 48h. Rapid methods like dipstick tests are used as point-of-care tests. However, their sensitivity and specificity are variable. In this work, a rapid immunochromatographic test (IT) for detecting Escherichia coli in urine was developed, and its performance was evaluated in urine samples from patients with suspected UTI. The "universal lateral flow assay kit" was employed using an E. coli capture antibody. One hundred and five (105) urine samples were analyzed using the IT, dipstick test, and urine culture. The sensitivity of the IT was 74.5%, specificity 88.9%, positive predictive value (PPV) 86.3%, and negative predictive value (NPV) 78.7%. The combination of the IT with the dipstick test increases sensitivity to 94.1%, specificity to 66.7%, PPV to 72.7%, and NPV to 92.3%. Using the IT for detecting E. coli in urine could be a valuable technique for UTI screening, showing better specificity and diagnostic precision but lower sensitivity than the dipstick test. Based on these results, we propose that the combined use of both screening techniques would allow a rapid and more precise diagnosis of UTI, rationalizing the indication for empirical antibiotics.

Keywords: Diagnóstico de infecciones urinarias; Diagnóstico rápido; Escherichia coli; Immunochromatographic test; Infecciones del tracto urinario; Point-of-care test; Prueba en punto de atención; Rapid diagnosis; Test inmunocromatográfico; Urinary infection diagnosis; Urinary tract infection.