Patients with urinary tract infections (UTIs) may soon have access to the right antibiotics more quickly, thanks to a new test that provides results in hours rather than days.
Scientists from the University of Reading, in collaboration with researchers from the University of Southampton and Hampshire Hospitals NHS Foundation Trust, have developed a method to directly analyze urine samples. On average, this test can determine which antibiotics are effective in about 5.85 hours. With current testing methods, it typically takes two to three days to obtain the same information.
Study finds rapid urinary tract infection test highly accurate
The study, funded by the National Institute for Health and Care Research (NIHR) and published in the journal Antimicrobial Chemotherapy on March 31, evaluated 352 urine samples taken from patients with suspected urinary tract infections. The results of the new test matched standard laboratory testing methods in 96.95% of cases for seven first-line antibiotics used to treat urinary tract infections.
The second analysis focused on 90 duplicate samples to determine whether storage conditions affected accuracy. The researchers compared samples collected with and without preservatives and found a 98.75% agreement between the results, indicating that preservatives do not interfere with the test.
Dr Oliver Hancox, chief executive of Astratus Limited, a spin-out company from the University of Reading that will bring the test to market, said: “By the time a laboratory delivers a result using current methods, patients may have already finished their antibiotics or been given antibiotics that don’t work.”
“Being able to tell doctors on the same day which antibiotic to use means patients can get the right treatment sooner, reducing the risk of resistance developing and the infection developing into deadly sepsis.”
Professor Mike Lewis, NIHR Director of Scientific Innovation, said: “This NIHR-funded research has the potential to provide a faster and more effective treatment for patients suffering from urinary tract infections, as well as tackling the wider challenge of antimicrobial resistance. Rapid urine tests are a great example of the real-world solution to AMR that the Government has committed to developing in its 10-year health plan.”
Why faster UTI diagnosis is important
According to NHS data, more than 800,000 people in the UK have been admitted to hospital due to urinary tract infections in the past five years. At the same time, around one in four urine samples tested in NHS laboratories contain bacteria that are resistant to commonly used antibiotics. In the UK alone, approximately 65 million urine samples are analyzed each year.
Current procedures require urine samples to be cultured overnight to allow the bacteria to grow before doctors can identify the bacteria and test for antibiotics. This process causes significant delays, often totaling 2-3 days.
Mechanism of direct urine test
The new method eliminates the need for overnight incubation, simplifying the testing process. A cartridge containing small tubes pre-filled with various antibiotics is placed directly onto the urine sample and inserted into the device.
The system then uses optical imaging to monitor bacterial growth within each tube. Once the bacteria has stopped growing, the antibiotic in that tube becomes effective. If growth continues, the drug is not suitable. This approach allows doctors to identify the correct treatment within six hours.
Professor Matthew Inada-Kim, acute consultant and AMR lead at Hampshire Hospitals NHS Foundation Trust and researcher at the University of Southampton, said: “Urinary tract infections are a common reason why patients require antibiotics and getting the right treatment first can save lives.”
“A test that works on samples that are already routinely collected and can provide answers within the same day is exactly the kind of tool that could change the way infectious diseases are managed in the real world.”
First study on sample preservation
To test their approach, the researchers used 352 urine samples that had already been collected during routine tests at Basingstoke and North Hampshire Hospital. They also conducted another experiment using 90 fresh samples from the emergency department.
They split each of these samples into two and added boric acid to one set to test whether the preservative affected the results. Results showed 98.75% agreement, confirming that preservatives do not reduce accuracy. This is the first study to directly compare archived and unarchived urine samples using a rapid, direct-to-urine test method.
A step forward towards rapid diagnosis
This result marks a significant milestone for Astratus Limited, the University of Reading spin-out company set up in November 2024 to bring the test to market.
