UTI test often fails to detect infection, say researchers

ladycatlover

ladycatlover

Senior Member (Voting Rights)
https://www.theguardian.com/society...w-uti-urinary-tract-infections-testing-method

The “gold standard” test for urinary tract infections (UTIs) is not fit for purpose, according to research which suggests that it fails to diagnose most chronic sufferers.
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Those who suffer most tend to be older women, who may be sent home time and again by the doctor because the UTI test is negative. But the test, which has been around since the 1950s and was adopted all over the world, is flawed, says Dr Jennifer Rohn, head of Urological Biology at University College London’s (UCL’s) Department of Renal Medicine in the Division of Medicine at the Royal Free Hospital.

Her team compared the results of the standard test – the midstream urine culture (MSU) – with DNA sequencing for 33 new patients with symptoms, 30 who were experiencing a relapse after having been treated and 29 controls with no symptoms. Their research, published in the Journal of Clinical Microbiology, found only six of the MSU tests were positive, while the DNA test identified infection in all the patients with symptoms.
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Tests negative, no treatment offered... Must be down to those medically unexplained symptoms? ;)
 
There's some good information on the website - CUTIC, about the Kass threshold for identifying a UTI and the limitations. The Kass threshold was actually based on a small number of pregnant women with kidney infections then extrapolated to UTIs. Kass himself noted that people with UTIs tend to drink a lot of fluids, diluting the bacteria in the urine.
http://www.cutic.co.uk/patients/why-are-my-tests-negative/

It's astounding (or maybe not!) that this threshold has been used for over 50 years, and little progress seems to be made in that time in identifying more effective testing for UTI's.

The CUTIC website also has a good summary sheet for GP's which I took along today when I saw the nurse practitioner. My GP had previously been adamant that microbiology would identify an infection, and that if the results were "normal" then there is no infection despite "typical" UTI symptoms.

The nurse practitioner was more open to the possibility of an infection, hopefully a short course of antibiotics will do the trick...if not back to the GP.

ETA thanks to @ladycatlover who flagged this up...and I vaguely remembered the post when this issue came up with my GP.
 
At the risk of becoming an ICD-11 bore...for anyone interested in how Interstitial cystitis is described in ICD-11:

https://icd.who.int/dev11/l-m/en#/http://id.who.int/icd/entity/1650709285

GC00.3 Interstitial cystitis

Parents:

16 Diseases of the genitourinary system
> Diseases of the urinary system
> Certain specified diseases of urinary system
> GC00.3 Interstitial cystitis

Description

Additional Information

(see https://icd.who.int/dev11/l-m/en#/http://id.who.int/icd/entity/1650709285
for Description and Additional Information texts as these are quite long)

--------------------------


Interstitial cystitis is also listed among the Index Terms for MG30.50 Chronic central neuropathic pain

under Chronic central post stroke pain

https://icd.who.int/dev11/l-m/en#/http://id.who.int/icd/entity/1297540670

MG30.50 Chronic central neuropathic pain

Parents:

21 Symptoms, signs or clinical findings, not elsewhere classified
>General symptoms, signs or clinical findings
>General symptoms
>Pain
>MG30 Chronic pain
>MG30.5 Chronic neuropathic pain
>MG30.50 Chronic central neuropathic pain

Again, see listing: https://icd.who.int/dev11/l-m/en#/http://id.who.int/icd/entity/1297540670 for the Description, Additional Information, Inclusions texts, as these are quite long.

All Index Terms:
  • Chronic central neuropathic pain
  • Chronic central neuropathic pain associated with spinal cord injury ⇒
  • Chronic central neuropathic pain associated with brain injury ⇒
  • Chronic central post stroke pain ⇒
    • BPS/IC - [bladder pain syndrome/interstitial cystitis]
    • painful bladder syndrome
    • PBS/IC - [painful bladder syndrome/interstitial cystitis]
  • Chronic central neuropathic pain associated with multiple sclerosis


Edit:

On June 19, 2019, a rep for the International Association for the Study of Pain (IASP), the NGO collaborating with WHO in the development of the Chronic pain and Chronic primary pain categories for ICD-11, submitted a proposal for Deletion of:

  • BPS/IC - [bladder pain syndrome/interstitial cystitis]
  • painful bladder syndrome
  • PBS/IC - [painful bladder syndrome/interstitial cystitis]

from under Synonyms to Chronic central post stroke pain. This proposal has not been processed yet but if approved, these terms in blue would be removed as Index terms under MG30.50 Chronic central neuropathic pain and from under Synonyms terms under Chronic central post stroke pain.
 
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Daisy said:
It's astounding (or maybe not!) that this threshold has been used for over 50 years, and little progress seems to be made in that time in identifying more effective testing for UTI's.
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Dare I suggest that this may be because women get more uti’s than men? (deepest apologies to our lovely gentlemen on this forum!) so it really is time for researchers to sort this out.
 
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