caa a22 4500 555311147 20200410031630.0 cr unu---uuuuu 190207s2018 xx s 000 0 eng 1932-6203 10.1371/journal.pone.0193255 doi (BORIS)oai:boris.unibe.ch:125570 610 ddc 29474463 pmid The development and validation of different decision-making tools to predict urine culture growth out of urine flow cytometry parameter [Elektronische Daten] [Martin Müller, Ruth Seidenberg, Sabine K. Schuh, Aristomenis Exadaktylos, Clyde B. Schechter, Alexander B. Leichtle, Wolf Hautz] publishedVersion openAccess eu-repo Objective Patients presenting with suspected urinary tract infection are common in every day emergency practice. Urine flow cytometry has replaced microscopic urine evaluation in many emergency departments, but interpretation of the results remains challenging. The aim of this study was to develop and validate tools that predict urine culture growth out of urine flow cytometry parameter. Methods This retrospective study included all adult patients that presented in a large emergency department between January and July 2017 with a suspected urinary tract infection and had a urine flow cytometry as well as a urine culture obtained. The objective was to identify urine flow cytometry parameters that reliably predict urine culture growth and mixed flora growth. The data set was split into a training (70%) and a validation set (30%) and different decision-making approaches were developed and validated. Results Relevant urine culture growth (respectively mixed flora growth) was found in 40.2% (7.2% respectively) of the 613 patients included. The number of leukocytes and bacteria in flow cytometry were highly associated with urine culture growth, but mixed flora growth could not be sufficiently predicted from the urine flow cytometry parameters. A decision tree, predictive value figures, a nomogram, and a cut-off table to predict urine culture growth from bacteria and leukocyte count were developed, validated and compared. Conclusions Urine flow cytometry parameters are insufficient to predict mixed flora growth. However, the prediction of urine culture growth based on bacteria and leukocyte count is highly accurate and the developed tools should be used as part of the decision-making process of ordering a urine culture or starting an antibiotic therapy if a urogenital infection is suspected. Müller Martin joint author Seidenberg Ruth joint author Schuh Sabine K. joint author Exadaktylos Aristomenis joint author Schechter Clyde B. joint author Leichtle Alexander B. joint author Hautz Wolf joint author PLoS ONE 13(2), e0193255 1932-6203 https://boris.unibe.ch/125570/1/journal.pone.0193255.pdf text/html WWW-Backlink auf das Repository 1 info:eu-repo/semantics/article boris PeerReviewed boris peerstatus BORIS 856 40 https://boris.unibe.ch/125570/1/journal.pone.0193255.pdf text/html WWW-Backlink auf das Repository BORIS 700 1- Müller Martin joint author BORIS 700 1- Seidenberg Ruth joint author BORIS 700 1- Schuh Sabine K. joint author BORIS 700 1- Exadaktylos Aristomenis joint author BORIS 700 1- Schechter Clyde B. joint author BORIS 700 1- Leichtle Alexander B. joint author BORIS 700 1- Hautz Wolf joint author BORIS 773 0- PLoS ONE 13(2), e0193255 1932-6203 BK010053 XK010053 XK010000 BORIS BORIS BORIS info:eu-repo/semantics/article openAccess