Scientific Calendar November 2025
The power of rapid diagnostics in UTI
I have had several UTI episodes in the past. How can diagnostics help in my case?
Since I had some UTI episodes before, there is no need to use diagnostics. Antibiotics should be prescribed directly, based on symptoms.
It is important to confirm the infection (e.g. by using a dipstick), but the resistance profile of the pathogen is irrelevant. If a UTI is confirmed, I should take the same drug as last time.
Each UTI episode needs to be diagnosed individually, including a susceptibility test, to ensure a proper antibiotic treatment as recommended by antibiotic stewardship programmes.
If a new UTI is confirmed, it is recommended to take the same drug as previously. If the treatment fails, a different antibiotic can be prescribed afterwards.
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Scientific background
Uncomplicated cystitis is among the most prevalent bacterial infections in women with structurally and functionally normal urinary tracts, affecting approximately one-third of women under 25 years of age [1]. The current diagnostic gold standard is urine culture followed by antibiotic susceptibility testing (AST), which requires skilled personnel and approximately 48 hours to yield results [2–4]. Consequently, patients with uncomplicated urinary tract infections (UTIs) are frequently treated empirically, often before microbiological confirmation. Although empirical therapy is supported by clinical guidelines, it has become increasingly unreliable due to dynamic local resistance patterns, leading to treatment failures, recurrent infections, and the selection of resistant bacterial strains [2, 4–5].
In most primary care settings, diagnosis is based on urine dipstick testing, which lacks sufficient specificity to confirm bacteriuria. As a result, some patients may receive unnecessary antibiotics, further driving antimicrobial resistance (AMR) and contributing to the global reduction in antibiotic effectiveness [2, 5]. Resistance rates to commonly prescribed antibiotics now reach up to 20% in uropathogens, highlighting the need for rapid, accurate, and evidence-based diagnostic tools in primary care [6].
Point-of-care testing (POCT) enables near-patient diagnostics with short turnaround times. However, existing POCT devices for UTIs cannot deliver same-visit AST results, delaying targeted treatment [7]. The PA-100 represents an innovative POCT system capable of detecting bacteriuria and performing automated AST within approximately 45 minutes, independent of operator expertise, with promising diagnostic performance [8].
Detailed content
The PA-100 AST System
The PA-100 AST System is a point-of-care analyser, designed for non-laboratory environments, that conducts phenotypic antibiotic susceptibility testing using a nano-culture approach with a testing cartridge on fresh native urine. This analyser provides two results: detection of bacteriuria within 15 minutes and a susceptibility test within an additional 15 to 30 minutes. The system is intended for use in the context of uncomplicated urinary tract infection, now referred to as ‘localised urinary tract infection’.
PA-AST Panel U-0501
The susceptibility testing is conducted within a single-use cartridge that requires no pre-treatment of the urine sample. The urine is simply pipetted into the cartridge and inserted into the PA-100 to start the analysis automatically. If the urine includes bacterial cells, they are trapped in 11,000 nano-channels and incubated in Müller-Hinton broth with or without one of the following antibiotics: amoxicillin/clavulanic acid, nitrofurantoin, trimethoprim, ciprofloxacin and fosfomycin. So far, the cartridge has been tested for the following five uropathogens: Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis and Staphylococcus saprophyticus.
Diagnostic performance of the PA-100
The PA-100 AST System has been investigated in comparison to current microbiological gold standards, including urine culture and antibiotic susceptibility testing using disk diffusion [8], highlighting a high diagnostic performance for the detection of bacteriuria with a sensitivity of 84% and a specificity of 99%, as well as an overall accuracy for susceptibility testing of 93% [8].
This comparison study also showed that the overall frequency of optimal treatment was significantly (34%, p < 0.0001) higher for the PA-100 AST System recommendation compared to routine clinical decision-making and demonstrated the potential of the PA-100 AST System to significantly (p < 0.0001) reduce ineffective or unnecessary antibiotic prescriptions in patients with UTI symptoms by up to 88% [8].
Proposing a new workflow for the management of localised UTI
The PA-100 AST System now allows informed clinical decision-making for localised urinary tract infection at the point of care, bringing the power of the laboratory to the doctor’s office and enabling a rapid, diagnostic-based workflow.
