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Image reference: Vos MG de, Zagorski M, McNally A, Bollenbach T. Interaction networks, ecological stability, and collective antibiotic tolerance in polymicrobial infections. PNAS. 2017;114(40):10666-10671.

Polymicrobial Infections in the Urinary Tract

The rate of polymicrobial infections, or infections involving two or more micro-organisms, is as high as 39% in urinary tract infections (UTI) (1). How can polymicrobial infections form in the urinary tract? Years of clinical research have established that many...
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CME Webinar – Watch On Demand Challenging UTI Dogma: Applying Basic Bladder Microbiome Research to the Clinic

The old “urine is sterile” dogma is wrong. The lower urinary tract possesses its own resident communities of microbes called the urinary microbiota or urobiome. The standard clinical microbiology urine test does a poor job of detecting the urobiome because it was...

Guidance UTI is Associated with 13.7% Reduction in Hospital Admissions Compared to SUC

Guidance® UTI Associated with a 13.7% Reduction in Hospitalization The health care industry is focused more than ever on reducing hospital visits and admissions. Results from a new study by Pathnostics®, titled “Utilization of M-PCR and P-AST™ for Diagnosis and...

The History of Culture Testing

It took nearly 2,500 years to get past the cutting edge practice of tasting urine to diagnose diseases. It has taken less than 150 years to advance from tasting urine, to clinical culture, and on to molecular diagnostics.   Hippocrates (460 – 377 BCE) is said to...

Urogenital Mycobacterium Tuberculosis: What Should Urologists Know?

Executive Summary M. tuberculosis is a bacterium that causes tuberculosis (TB)

Personalized Therapy Options for Recurrent UTI’s

Recurrent urinary tract infections (UTIs) present a significant health issue for women, with uncomplicated UTI occurring in at least 50% of women, and about 30% experiencing recurrent UTI (rUTI).1–3   Although there are multiple definitions for rUTI, the American...

Human Herpes Virus 6 (HHV-6)

Overview Although both typically cause dermatological infections and both can be a factor in transplant rejection, both have also been found in the bladder and vagina.


How does Guidance UTI's Pooled Antibiotic Susceptibility Testing (P-AST)™ differ from traditional methods?

Standard culture tests susceptibility on individual organisms, which doesn’t reflect what happens in the body with a polymicrobial infection.  However, testing in a pooled environment, where organisms are grouped together, takes into consideration bacterial interactions.  Guidance UTI’s Pooled Antibiotic Susceptibility Testing (P-AST™) method evaluates 19 different antibiotics against the pool of organisms in the patient’s urine, providing a personalized result that accounts for bacterial interactions that may change antibiotic resistance.

How will I know if Guidance UTI results are providing proof of a true infection versus contamination? Is the test too sensitive?

Guidance UTI detects organisms that are often missed by culture. This does not suggest that these are rare organisms with relatively low bacterial loads. In fact, most uropathogens found via Guidance UTI have a bacterial count of >100,000 cells/mL. Studies show that standard urine techniques fail to spot a high proportion (67%) of uropathogens that may be clinically relevant.8 Other independent studies have shown that molecular identification of organisms acquired through transurethral catheter (TUC) or subpubic aspirate (SPA) are highly similar. Those acquired by voided urine were also similar, except the sample contained bacteria associated with vulvo-vaginal contamination. Of the microbes suspected to be vulvo-vaginal contaminants, only one of the detected species aligns with the Guidance UTI profile. Guidance UTI also quantitates organisms so that physicians can treat the organisms that are above a certain threshold for patients with symptoms of a UTI.9

It is the physician’s prerogative to determine when and how to treat a patient based on clinical symptoms and the presence of bacteria, virus, or yeast in the urine.

Internal data shows that 67% of cases with a bacterial load of 10,000 cells/mL or greater are typically at 100,000 cells/mL and higher. Contamination would typically result in a lower bacterial load.

How does the Guidance UTI cells/mL result compare with a CFU/mL result by urine culture? How did you establish the cutoff value?

Serial dilutions were used to compare CFU/mL and cells/mL during our validation studies. We found that the CFU/mL and cells/mL units were similar for most organisms, with the molecular assay illustrating a longer and more accurate linear range. The threshold for clinical significance remains the same for both technologies and reporting units.


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