1
|
Kumar S, Kaushal JB, Lee HP. Sustainable Sensing with Paper Microfluidics: Applications in Health, Environment, and Food Safety. BIOSENSORS 2024; 14:300. [PMID: 38920604 PMCID: PMC11202065 DOI: 10.3390/bios14060300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024]
Abstract
This manuscript offers a concise overview of paper microfluidics, emphasizing its sustainable sensing applications in healthcare, environmental monitoring, and food safety. Researchers have developed innovative sensing platforms for detecting pathogens, pollutants, and contaminants by leveraging the paper's unique properties, such as biodegradability and affordability. These portable, low-cost sensors facilitate rapid diagnostics and on-site analysis, making them invaluable tools for resource-limited settings. This review discusses the fabrication techniques, principles, and applications of paper microfluidics, showcasing its potential to address pressing challenges and enhance human health and environmental sustainability.
Collapse
Affiliation(s)
- Sanjay Kumar
- Durham School of Architectural Engineering and Construction, University of Nebraska-Lincoln, Scott Campus, Omaha, NE 68182-0816, USA
| | - Jyoti Bala Kaushal
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Heow Pueh Lee
- Department of Mechanical Engineering, National University of Singapore, 9 Engineering Drive 1, Singapore 117575, Singapore;
| |
Collapse
|
2
|
Waldecker-Gall S, Waldecker CB, Babel N, Baraliakos X, Seibert F, Westhoff TH. Urinary calprotectin as a diagnostic tool for detecting significant bacteriuria. Sci Rep 2024; 14:12230. [PMID: 38806578 PMCID: PMC11133377 DOI: 10.1038/s41598-024-62605-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/20/2024] [Indexed: 05/30/2024] Open
Abstract
Pyuria in dipstick examination serves as the most widespread screening tool for urinary tract infections (UTI). The absence of pyuria, however, does not exclude UTI. We investigated the diagnostic value of urinary calprotectin, a mediator protein of the innate immune system, which is released by leukocytes, for the detection of UTI and compared it with dipstick pyuria. Since even low numbers of leukocytes in the urine significantly increase urinary calprotectin concentrations, calprotectin might be a more sensitive marker than pyuria detected by dipstick. All 162 patients were prospectively included and underwent a urine dipstick, urine culture, quantification of proteinuria and determination of calprotectin in the urine. Urinary calprotectin was determined using an enzyme-linked immunosorbent assay (ELISA). UTI was defined as urine cultures with detection of one or a maximum of two uropathogenic bacteria with ≥ 105 colony-forming units per millilitre (CFU/ml). Exclusion criteria were acute kidney injury, chronic renal insufficiency and tumors of the urinary tract. 71 (43.8%) patients had a UTI. Of the 91 patients without UTI, 23 had a contamination and 19 had evidence of ≥ 105 CFU/ml considered to be asymptomatic bacteriuria. The median calprotectin concentration in patients with UTI and pyuria was significantly higher than in patients with UTI and without pyuria (5510.4 vs. 544.7 ng/ml). In ROC analyses, calprotectin revealed an area under the curve (AUC) of 0.70 for the detection of significant bacteriuria. Pyuria in dipstick examinations provided an AUC of 0.71. There was no significant difference between these AUCs in the DeLong test (p = 0.9). In patients with evidence of significant bacteriuria but without pyuria, a significantly higher calprotectin concentration was measured in the urine than in patients with neither pyuria nor UTI (544.7 ng/ml vs 95.6 ng/ml, p = 0.029). Urinary calprotectin is non-inferior to dipstick pyuria in the detection of UTI.
Collapse
Affiliation(s)
| | | | - Nina Babel
- Center for Translational Medicine, University Hospital Marien Hospital Herne, Ruhr University Bochum, Herne, Germany
| | | | - Felix Seibert
- Medical Department 1, University Hospital Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Timm H Westhoff
- Medical Department 1, University Hospital Marien Hospital Herne, Ruhr-University Bochum, Hölkeskampring 40, 44625, Herne, Germany.
| |
Collapse
|
3
|
Almuhanna HS, Alhojelan AM, Al Rusayni YA, Almohanna MA, AlDhalea HM, Aljulajil AA. Comparison Between Urine Dipstick and Microscopic Examination Urinalysis With Urine Culture to Evaluate the Sensitivity and Specificity for Each in Diagnosing Urinary Tract Infection in Qassim Region, Saudi Arabia. Cureus 2024; 16:e59069. [PMID: 38800344 PMCID: PMC11128248 DOI: 10.7759/cureus.59069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Urinalysis is the most popular test for evaluating emergency room patients with possible urinary tract infections (UTIs). Due to their speed and inexpensive cost, urine dipsticks are frequently performed in the Emergency Room. Although a urine dipstick test may be less expensive and time-saving than a laboratory study, it may not be accurate. The study evaluated the sensitivity and specificity of urine dipstick and microscopic urinalysis with a urine culture. METHODOLOGY A prospective, observational study was conducted on adults who visited the Emergency Department at King Fahd Specialist Hospital in Buraydah and reported having dysuria, urine urgency, or frequency, as well as suprapubic or costovertebral angle soreness. Patients who could not give a trustworthy history, had symptoms of vaginal discharge, or had taken antibiotics within the previous 72 hours were excluded. RESULTS One hundred fifty-three urine samples were collected and examined using urinalysis and dipstick. In addition, 113 (73.86%) of 153 urine samples exhibited no growth in urine culture. With a count of nine, Escherichia coli (E. coli) was the most often isolated organism among the positive cultures (5.88%). Klebsiella pneumoniae was the second most common in our sample with eight (5.23%). The urine dipstick was shown to have an overall sensitivity of 0.79, specificity of 0.39, positive productive value (PPV) of 0.30, and negative productive value (NPV) of 0.85. Urinalysis exhibited a high sensitivity of 0.95 and a poor specificity of 0.21. CONCLUSION Our study showed that urine dipsticks may be more beneficial than urinalysis for ruling out urinary tract infections (UTIs), while urinalysis may be more helpful in verifying their presence.
Collapse
Affiliation(s)
- Hana S Almuhanna
- Emergency Medicine Department, Buraydah Central Hospital, Buraydah, SAU
| | - Ali M Alhojelan
- Emergency Medicine Department, King Fahad Specialist Hospital, Buraydah, SAU
| | - Yasir A Al Rusayni
- Emergency Medicine Department, King Fahad Specialist Hospital, Buraydah, SAU
| | | | - Hatem M AlDhalea
- Emergency Medicine Department, King Fahad Specialist Hospital, Buraydah, SAU
| | | |
Collapse
|
4
|
Grey B, Upton M, Joshi LT. Urinary tract infections: a review of the current diagnostics landscape. J Med Microbiol 2023; 72. [PMID: 37966174 DOI: 10.1099/jmm.0.001780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023] Open
Abstract
Urinary tract infections are the most common bacterial infections worldwide. Infections can range from mild, recurrent (rUTI) to complicated (cUTIs), and are predominantly caused by uropathogenic Escherichia coli (UPEC). Antibiotic therapy is important to tackle infection; however, with the continued emergence of antibiotic resistance there is an urgent need to monitor the use of effective antibiotics through better stewardship measures. Currently, clinical diagnosis of UTIs relies on empiric methods supported by laboratory testing including cellular analysis (of both human and bacterial cells), dipstick analysis and phenotypic culture. Therefore, development of novel, sensitive and specific diagnostics is an important means to rationalise antibiotic therapy in patients. This review discusses the current diagnostic landscape and highlights promising novel diagnostic technologies in development that could aid in treatment and management of antibiotic-resistant UTIs.
Collapse
Affiliation(s)
- Braith Grey
- Peninsula Dental School, Faculty of Health, University of Plymouth, Plymouth, Devon, UK
| | - Mathew Upton
- School of Biomedical Sciences, Faculty of Health, University of Plymouth, Plymouth, Devon, UK
| | - Lovleen Tina Joshi
- Peninsula Dental School, Faculty of Health, University of Plymouth, Plymouth, Devon, UK
| |
Collapse
|
5
|
Maina J, Mwaniki J, Mwiti F, Kiiru S, Katana J, Wanja F, Mukaya J, Khasabuli O, Asiimwe B, Gillespie S, Stelling J, Mshana S, Holden M, Sabiiti W, Kiiru J. Evaluation of the diagnostic performance of the urine dipstick test for the detection of urinary tract infections in patients treated in Kenyan hospitals. Access Microbiol 2023; 5:acmi000483.v3. [PMID: 37424559 PMCID: PMC10323778 DOI: 10.1099/acmi.0.000483.v3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 05/10/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Culture is the gold-standard diagnosis for urinary tract infections (UTIs). However, most hospitals in low-resource countries lack adequately equipped laboratories and relevant expertise to perform culture and, therefore, rely heavily on dipstick tests for UTI diagnosis. Research gap In many Kenyan hospitals, routine evaluations are rarely done to assess the accuracy of popular screening tests such as the dipstick test. As such, there is a substantial risk of misdiagnosis emanating from inaccuracy in proxy screening tests. This may result in misuse, under-use or over-use of antimicrobials. Aim The present study aimed to assess the accuracy of the urine dipstick test as a proxy for the diagnosis of UTIs in selected Kenyan hospitals. Methods A hospital-based cross-sectional method was used. The utility of dipstick in the diagnosis of UTIs was assessed using midstream urine against culture as the gold standard. Results The dipstick test predicted 1416 positive UTIs, but only 1027 were confirmed positive by culture, translating to a prevalence of 54.1 %. The sensitivity of the dipstick test was better when leucocytes and nitrite tests were combined (63.1 %) than when the two tests were separate (62.6 and 50.7 %, respectively). Similarly, the two tests combined had a better positive predictive value (87.0 %) than either test alone. The nitrite test had the best specificity (89.8 %) and negative predictive value (97.4 %) than leucocytes esterase (L.E) or both tests combined. In addition, sensitivity in samples from inpatients (69.2 %) was higher than from outpatients (62.7 %). Furthermore, the dipstick test had a better sensitivity and positive predictive value among female (66.0 and 88.6 %) than male patients (44.3 and 73.9 %). Among the various patient age groups, the dipstick test's sensitivity and positive predictive value were exceptionally high in patients ≥75 years old (87.5 and 93.3 %). Conclusion Discrepancies in prevalence from the urine dipstick test and culture, the gold standard, indicate dipstick test inadequacy for accurate UTI diagnosis. The finding also demonstrates the need for urine culture for accurate UTI diagnosis. However, considering it is not always possible to perform a culture, especially in low-resource settings, future studies are needed to combine specific UTI symptoms and dipstick results to assess possible increases in the test's sensitivity. There is also a need to develop readily available and affordable algorithms that can detect UTIs where culture is not available.
Collapse
Affiliation(s)
- John Maina
- Kenya Medical Research Institute, Centre for Microbiology Research, Nairobi, Kenya
| | - John Mwaniki
- Kenya Medical Research Institute, Centre for Microbiology Research, Nairobi, Kenya
| | - Franklin Mwiti
- Kenya Medical Research Institute, Centre for Microbiology Research, Nairobi, Kenya
| | - Susan Kiiru
- Kenya Medical Research Institute, Centre for Microbiology Research, Nairobi, Kenya
| | - Japhet Katana
- Kenya Medical Research Institute, Centre for Microbiology Research, Nairobi, Kenya
| | - Fredrick Wanja
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | | | - Osborn Khasabuli
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | | | | | - John Stelling
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Stephen Mshana
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Matthew Holden
- University of St Andrews, School of Medicine, St Andrews, UK
| | - Wilber Sabiiti
- University of St Andrews, School of Medicine, St Andrews, UK
| | - John Kiiru
- Kenya Medical Research Institute, Centre for Microbiology Research, Nairobi, Kenya
- Ministry of Health, Nairobi, Kenya
| | - HATUA consortium
- Kenya Medical Research Institute, Centre for Microbiology Research, Nairobi, Kenya
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
- Kentyatta National Hospital, Nairobi, Kenya
- Makerere University, Kampala, Uganda
- University of St Andrews, School of Medicine, St Andrews, UK
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania
- Ministry of Health, Nairobi, Kenya
| |
Collapse
|
6
|
Lomae A, Preechakasedkit P, Teekayupak K, Panraksa Y, Yukird J, Chailapakul O, Ruecha N. Microfluidic Paper-Based Device for Medicinal Diagnosis. Curr Top Med Chem 2022; 22:CTMC-EPUB-127355. [PMID: 36330618 DOI: 10.2174/1568026623666221103103211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/16/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The demand for point-of-care testing (POCT) devices has rapidly grown since they offer immediate test results with ease of use, makingthem suitable for home self-testing patients and caretakers. However, the POCT development has faced the challenges of increased cost and limited resources. Therefore, the paper substrate as a low-cost material has been employed to develop a cost-effective POCT device, known as "Microfluidic paper-based analytical devices (μPADs)". This device is gaining attention as a promising tool for medicinal diagnostic applications owing to its unique features of simple fabrication, low cost, enabling manipulation flow (capillarydriven flow), the ability to store reagents, and accommodating multistep assay requirements. OBJECTIVE This review comprehensively examines the fabrication methods and device designs (2D/3D configuration) and their advantages and disadvantages, focusing on updated μPADs applications for motif identification. METHODS The evolution of paper-based devices, starting from the traditional devices of dipstick and lateral flow assay (LFA) with μPADs, has been described. Patterned structure fabrication of each technique has been compared among the equipment used, benefits, and drawbacks. Microfluidic device designs, including 2D and 3D configurations, have been introduced as well as their modifications. Various designs of μPADs have been integrated with many powerful detection methods such as colorimetry, electrochemistry, fluorescence, chemiluminescence, electrochemiluminescence, and SER-based sensors for medicinal diagnosis applications. CONCLUSION The μPADs potential to deal with commercialization in terms of the state-of-the-art of μPADs in medicinal diagnosis has been discussed. A great prototype, which is currently in a reallife application breakthrough, has been updated.
Collapse
Affiliation(s)
- Atchara Lomae
- Electrochemistry and Optical Spectroscopy Center of Excellence (EOSCE), Department of Chemistry, Faculty of Science, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok 10330, Thailand
- Metallurgy and Materials Science Research Institute, Chulalongkorn University, Soi Chula 12, Phayathai Rd., Pathumwan, Bangkok 10330, Thailand
| | - Pattarachaya Preechakasedkit
- Metallurgy and Materials Science Research Institute, Chulalongkorn University, Soi Chula 12, Phayathai Rd., Pathumwan, Bangkok 10330, Thailand
| | - Kanyapat Teekayupak
- Electrochemistry and Optical Spectroscopy Center of Excellence (EOSCE), Department of Chemistry, Faculty of Science, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok 10330, Thailand
| | - Yosita Panraksa
- Electrochemistry and Optical Spectroscopy Center of Excellence (EOSCE), Department of Chemistry, Faculty of Science, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok 10330, Thailand
| | - Jutiporn Yukird
- Metallurgy and Materials Science Research Institute, Chulalongkorn University, Soi Chula 12, Phayathai Rd., Pathumwan, Bangkok 10330, Thailand
| | - Orawon Chailapakul
- Electrochemistry and Optical Spectroscopy Center of Excellence (EOSCE), Department of Chemistry, Faculty of Science, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok 10330, Thailand
| | - Nipapan Ruecha
- Metallurgy and Materials Science Research Institute, Chulalongkorn University, Soi Chula 12, Phayathai Rd., Pathumwan, Bangkok 10330, Thailand
| |
Collapse
|
7
|
Guo S, Zhang X, Li F, Sun C, Zhang Y, Cao X. One-stage tubeless percutaneous nephrolithotomy for asymptomatic calculous pyonephrosis. BMC Urol 2022; 22:29. [PMID: 35255872 PMCID: PMC8902711 DOI: 10.1186/s12894-022-00983-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background In recent years, the safety and effectiveness of one-stage percutaneous nephrolithotomy (PCNL) for the treatment of calculous pyonephrosis have been proven. In order to further reduce postoperative pain and hospital stay, we first proposed and practiced the idea of one-stage tubeless percutaneous nephrolithotomy for calculous pyonephrosis. Methods A retrospective analysis was performed of case data of 30 patients with asymptomatic calculous pyonephrosis treated in our center with one-stage PCNL from January 2016 to January 2021. Patients were routinely given 20 mg of furosemide and 10 mg of dexamethasone sodium phosphate injection intravenously at the beginning of anesthesia. Among them, 27 patients successfully underwent one-stage tubeless percutaneous nephrolithotomy, while 3 cases were given indwelling nephrostomy tubes because of proposed second-stage surgery or the number of channels was greater than or equal to 3. All patients were operated on by the same surgeon. Results Preoperatively, 11 of 30 patients (8 men and 22 women) had positive urine bacterial cultures, and all were given appropriate antibiotics based on drug sensitivity tests. All patients completed the surgery successfully. The mean operative time was 66.6 ± 34.7 min, the mean estimated blood loss was 16.67 ± 14.34 mL and the mean postoperative hospital stay was 5.0 ± 3.1 days. The mean postoperative hospital stay was 4.6 ± 2.5 days among the 27 patients with one-stage tubeless percutaneous nephrolithotomy. Of the 3 patients with postoperative fever, 2 had the tubeless technique applied. One patient with 3 channels was given renal artery interventional embolization for control of postoperative bleeding. None of the 30 patients included in the study developed sepsis. The final stone-free rate was 93.3% (28/30) on repeat computed tomography at 1 month postoperatively. The final stone-free rate was 92.6% in the 27 patients undergoing one-stage tubeless percutaneous nephrolithotomy (25/27). Conclusions One-stage tubeless PCNL is an available and safe option in carefully evaluated and selected calculous pyonephrosis patients.
Collapse
Affiliation(s)
- Shijie Guo
- Clinical Medical College of Jining Medical University, Jining, 272000, Shandong, China
| | - Xicai Zhang
- Clinical Medical College of Jining Medical University, Jining, 272000, Shandong, China
| | - Fengyue Li
- Clinical Medical College of Jining Medical University, Jining, 272000, Shandong, China
| | - Chunyue Sun
- Clinical Medical College of Jining Medical University, Jining, 272000, Shandong, China
| | - Yonghe Zhang
- Clinical Medical College of Jining Medical University, Jining, 272000, Shandong, China
| | - Xiande Cao
- Department of Urology, Affiliated Hospital of Jining Medical University, Jining, 272000, Shandong, China.
| |
Collapse
|
8
|
Abstract
Regular health monitoring can result in early detection of disease, accelerate the delivery of medical care and, therefore, considerably improve patient outcomes for countless medical conditions that affect public health. A substantial unmet need remains for technologies that can transform the status quo of reactive health care to preventive, evidence-based, person-centred care. With this goal in mind, platforms that can be easily integrated into people's daily lives and identify a range of biomarkers for health and disease are desirable. However, urine - a biological fluid that is produced in large volumes every day and can be obtained with zero pain, without affecting the daily routine of individuals, and has the most biologically rich content - is discarded into sewers on a regular basis without being processed or monitored. Toilet-based health-monitoring tools in the form of smart toilets could offer preventive home-based continuous health monitoring for early diagnosis of diseases while being connected to data servers (using the Internet of Things) to enable collection of the health status of users. In addition, machine learning methods can assist clinicians to classify, quantify and interpret collected data more rapidly and accurately than they were able to previously. Meanwhile, challenges associated with user acceptance, privacy and test frequency optimization should be considered to facilitate the acceptance of smart toilets in society.
Collapse
Affiliation(s)
- Savas Tasoglu
- Department of Mechanical Engineering, Koc University, Istanbul, Turkey. .,Koç University Translational Medicine Research Center (KUTTAM), Koç University, Sarıyer, Istanbul, Turkey. .,Boğaziçi Institute of Biomedical Engineering, Boğaziçi University, Çengelköy, Istanbul, Turkey. .,Physical Intelligence Department, Max Planck Institute for Intelligent Systems, Stuttgart, Germany.
| |
Collapse
|
9
|
A global perspective on improving patient care in uncomplicated urinary tract infection: Expert consensus and practical guidance. J Glob Antimicrob Resist 2021; 28:18-29. [PMID: 34896337 DOI: 10.1016/j.jgar.2021.11.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/01/2021] [Accepted: 11/15/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Uncomplicated urinary tract infections (uUTIs) are a common problem in women. Management is mainly based on empirical prescribing, but there are concerns about overtreatment and antimicrobial resistance (AMR), especially in patients with recurrent uUTIs. METHODS A multidisciplinary panel of experts met to discuss diagnosis, treatment, prevention, guidelines, AMR, clinical trial design, and the impact of COVID-19 on clinical practice. RESULTS Symptoms remain the cornerstone of uUTI diagnosis, and urine culture is necessary only when empirical treatment fails, or rapid recurrence of symptoms or AMR is suspected. Specific antimicrobials are first-line therapy (typically nitrofurantoin, fosfomycin, trimethoprim-sulfamethoxazole, and pivmecillinam; dependent on availability and local resistance data). Fluoroquinolones are not first-line options for uUTIs due primarily to safety concerns, but also rising resistance rates. High-quality data to support most non-antimicrobial approaches are lacking. Local AMR data specific to community-acquired uUTIs are needed, but representative information is difficult to obtain; instead, identification of risk factors for AMR can provide a basis to guide empirical antimicrobial prescribing. The COVID-19 pandemic has impacted management of uUTIs in some countries and may have long-lasting implications for future models of care. CONCLUSIONS The management of uUTIs in women can be improved without increasing complexity, including simplified diagnosis, and empirical antimicrobial prescribing based on patient characteristics, including review of recent antimicrobial use and past pathogen resistance profiles, drug availability, and guidelines. Current data for non-antimicrobial approaches are limited. The influence of COVID-19 on telehealth could provide an opportunity to enhance patient care in the long term.
Collapse
|
10
|
|