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Abstract: Objective: We performed a multicenter study to calculate the upper reference limits (URL) for urine particle quantification in mid-stream samples by using automated urine analyzers. Design & methods: Two laboratories tested 283 subjects using a Sysmex UF-100, two other laboratories tested 313 subjects using Sysmex UF-1000i, whereas two other laboratories tested 267 subjects using Iris IQ®200. Results: The URLs of UF-100 in females and males were 7.8/μL and 6.7/μL for epithelial cells (EC), 11.1/μL and 9.9/μL for red blood cells (RBC), 10.2/μL and 9.7/μL for white blood cells (WBC), and 0.85/μL and 0.87/μL for cylinders (CAST). The URLs of UF-1000i in females and males were 7.6/μL and 7.1/μL for EC, 12.2/μL and 11.1/μL for RBC, 11.9/μL and 11.7/μL for WBC, and 0.88/μL and 0.86/μL for CAST. The URLs of Iris IQ®200 in females and males were 7.8/μL and 6.6/μL for EC, 12.4/μL and 10.1/μL for RBC, 10.9/μL and 9.9/μL for WBC, and 1.1/μL and 1.0/μL for CAST. Conclusion: The URLs obtained in this study were comparable to the lowest values previously reported in the literature. Moreover, no gender-related difference was observed, and analyzer-specific upper reference limits were very similar. [Copyright &y& Elsevier]

Abstract: Background: Urinary tract infections (UTIs) are usually diagnosed by urine particle detection and urine bacterial culturing, but an empiric treatment is often prescribed before the microbiological results are known. The aim of this study was to assess whether quantification of bacteriuria and leukocyturia could predict the outcome of empiric antibiotic therapy. Methods: By using a Sysmex UF-100 analyser, we performed a case–control study in which bact channel counts (BCCs) and leukocyte (WBC) quantification were compared in urine samples obtained from responsive patients (RPs) and non-responsive patients (NRPs) at diagnosis (t0) and 24h (t24) after the start of empiric antibacterial treatment. Results: BCCs decreased significantly from t0 (median: 30,000 E6/L) to t24 (median: 700 E6/L; p <0.001) in RPs but not in NRPs (median at t0 31,000 E6/L, and 23,000 E6/L at t24; p >0.05). Similarly, WBC counts were reduced in RPs at t24 relative to the initial values (p <0.001) but not in NRPs. A reduction of 70% in the BCC count or 60% in the WBC count of paired samples was useful for discriminating between RPs and NRPs. Conclusions: Our results suggest that quantitative time course analysis of urine BCCs and WBCs can be used to predict the success of first-line empiric treatment for UTIs. [Copyright &y& Elsevier]