JOJ Urology & Nephrology
Utilization of M-PCR and P-AST for Diagnosis and Management of Urinary Tract Infections in Home-Based Primary Care
Author: Annemarie Daly, David Baunoch*, Kelly Rehling, Natalie Luke, Meghan Campbell, Patrick Cacdac, Miguel Penaranda, Michael Opel, Shuguang Huang, Xinhua Zhao and Kirk Wojno
Published: March 27, 2020
DOI: 10.19080/JOJUN.2020.07.555707
Abstract Content: Background/Objective: Urinary tract infections are common, especially among the elderly, and are associated with higher rates for both emergency department utilization and hospitalization. Improvements in diagnostic accuracy and timeliness may enable better outpatient care and thereby reduce emergency department utilization and hospital admission rates. Methods: This was a retrospective study of existing data from 66,383 patients seen for possible urinary tract infection by house-call primary care providers. Patients were divided into two cohorts. One cohort of patients was treated based upon the results from Standard Urine Cultures (SUC). The other cohort was treated in accordance with results from an assay combining Multiplex-Polymerase Chain Reaction (M-PCR) and Pooled Antibiotic Susceptibility Testing (P-AST) of urine specimens. The total number of emergency department visits and hospitalizations were compared between the two cohorts. Results: We found that the use of the combined M-PCR/P-AST was associated with a 13.7% decrease in hospital admissions and/or emergency department utilization when compared to the use of SUC testing (3.27% vs. 3.79%; p = 0.003). Conclusions: These findings suggest that use of a combined M-PCR/P-AST assay in outpatient management of suspected urinary tract infection may improve patient outcomes and reduce emergency department and hospital utilization.