GUIDANCE 4.5 From Pathnostics: The most extensive UTI pathogen testing available

At least 50% of women experience a urinary tract infection (UTI), and about 30% suffer recurrent UTI (rUTI). Of those women who have rUTI, nearly 62% face between 4 and 10 UTIs per year.1–3


Although poor patient compliance with treatment and emergence of de novo pathogen resistance can both cause rUTI, more effective treatment of an initial UTI may avoid recurrence. Efficacious treatment depends on accurate identification of causative pathogen(s) and thorough assessment of pathogen resistance.


Pathnostics, a diagnostics solutions company, has announced that GUIDANCE, a suite of rapid novel urine tests, will include additional pathogens beginning in September 2018. GUIDANCE already provides the most extensive testing available for UTI, prostatitis, and interstitial cystitis, including identification of 42 different pathogens, testing for 38 antibiotic resistance genes, and pooled phenotypic sensitivity assays. Learn more about how to bring GUIDANCE testing to your practice today.


On September 5, 2018, GUIDANCE Comprehensive will include testing for three new pathogens:


Streptococcus pyogenes

• Human herpesvirus-6

• Human herpesvirus-7


Streptococcus pyogenes is the predominant species in Group A Streptococcus. Infection with Group A Streptococcus is one of the top ten causes of infection-related mortality worldwide. As a genitourinary tract infection, S. pyogenes is most commonly found as a postpartum and gynecological infection and can cause puerperal sepsis following genitourinary tract infection.


GUIDANCE Comprehensive already offers HSV 1&2. The tests now also reports results for HHV 6 and 7. Much like other herpesviruses, HHV-6 and -7 can reside as a latent infection for extended periods, sometimes decades, without manifest illness. HHV-6 and -7 are double-stranded DNA viruses and are unique in their ability to incorporate viral DNA into the host nuclear genome. Both latent infection and chromosomally incorporated DNA can become activated and form an active infection at any time.


Although it may seem intuitively obvious, a more comprehensive diagnostic menu presents significant advantages for effective treatment. Missing one causative pathogenic organism can affect treatment of other organisms. The rate of polymicrobial infections in UTI may be 39% or higher, and polymicrobial infections are more likely to harbor antimicrobial resistance; one organism can confer resistance on another that may not (yet) carry genes for antibiotic resistance.4–7


GUIDANCE includes both genotyping for resistance genes and phenotyping for antibiotic sensitivity.
Learn more about how to bring GUIDANCE testing to your practice today.


1. Gupta, K. & Trautner, B. W. Diagnosis and management of recurrent urinary tract infections in non-pregnant women. BMJ 346, (2013).
2. Hooton, T. M., Roberts, P. L., Cox, M. E. & Stapleton, A. E. Voided Midstream Urine Culture and Acute Cystitis in Premenopausal Women. N Engl J Med 369, 1883–1891 (2013).
3. Wagenlehner, F., Wullt, B., Ballarini, S., Zingg, D. & Naber, K. G. Social and economic burden of recurrent urinary tract infections and quality of life: a patient web-based study (GESPRIT). Expert Rev Pharmacoecon Outcomes Res 18, 107–117 (2018).
4. de Vos, M. G. J., Zagorski, M., McNally, A. & Bollenbach, T. Interaction networks, ecological stability, and collective antibiotic tolerance in polymicrobial infections. Proc. Natl. Acad. Sci. U.S.A. 114, 10666–10671 (2017).
5. Hilt, E. E. et al. Urine is not sterile: use of enhanced urine culture techniques to detect resident bacterial flora in the adult female bladder. J. Clin. Microbiol. 52, 871–876 (2014).
6. Murray, J. L., Connell, J. L., Stacy, A., Turner, K. H. & Whiteley, M. Mechanisms of synergy in polymicrobial infections. J. Microbiol. 52, 188–199 (2014).
7. Price, T. K. et al. The Clinical Urine Culture: Enhanced Techniques Improve Detection of Clinically Relevant Microorganisms. J. Clin. Microbiol. 54, 1216–1222 (2016).