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Master Thesis

Apport de l'approche syndromique dans le diagnostic rapide des infections urinaires graves et à risque de complication

Abstract : Severe urinary tract infections (UTI) require rapid and targeted antibiotic therapy. To date, the diagnosis of UTI is based on urine culture with antimicrobial susceptibility testing results available in 48 hours. The Unyvero® system (Curetis, Germany) is a multiplex PCR made for the syndromic approach. The Unyvero UTI enables the identification of microorganisms and the detection of resistance genes, in less than 5 hours. The aim of this work was to evaluate the performance of this kit for the rapid diagnosis of severe UTI. 113 urinary samples from patients with severe UTI or UTI with risk of complication were collected in tertiary hospital of Caen and analysed by classical method (culture) and with the Unyvero UTI® kit. Concerning microorganisms identification, performances were good with specificity and NPV at 98.3 % and 99. 9% respectively, but insufficient for sensitivity and PPV, with only 68.7 % and 50.0 %, respectively. Four resistance genes were mainly detected (blaCTX-M, mecA, qnrB / S and sul1) with good values of NPV (63.4 – 100 %) but their presence should not phenotypically be confirmed in many cases (PPV from 8,7 to 94.4 %). Compared to the culture, the Unyvero® UTI kit enables a certain gain of time concerning the result reporting time. This approach is complementary to the culture and should be reserved for severe UTIs that require early antibiotic therapy.
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Master Thesis
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Agathe Capitaine. Apport de l'approche syndromique dans le diagnostic rapide des infections urinaires graves et à risque de complication. Sciences pharmaceutiques. 2019. ⟨dumas-02450536⟩