NMR Spectroscopy of Urine for the Detection of Urinary Tract Infection (UTI) in Children

INTRODUCTION: Urinary tract infection (UTI) is the most common non-epidemic bacterial infection in adults and children. Infections to the kidneys and scarring are well established complications of infection of the upper urinary tract in children and can lead to hypertension and renal failure [1]. The reference standard for confirmation of UTI in children is growth of a single organism on a culture of urine obtained by urethralcatheterization/suprapubic aspiration. Escherichia coli is the most common uropathogen causing UTI in children, accounting for up to 78% [2]. However, other pathogens such as Proteus and Klebsiella species, and some Staphylococcus and Streptococcus species may also cause UTI. The culture method has the disadvantage of taking at least 48 hours to give a result. Therefore, more rapid methods are desirable. Currently, the most widely used rapid tests are dipsticks (leukocyte esterase and nitrite). Dipstick tests have the advantage of being quick and easy to perform, however, they are associated with false negative results for bacteria which do not produce nitrite and false positive results in the presence of ascorbic acid, drug interference and overgrowth with nitrite producing bacteria. For routine purposes, the ideal method for microbial characterization would require minimum sample preparation, be rapid, automated and inexpensive. In this study, we have tested if H NMR spectroscopy will be of value in differentiating metabolite profiles of urine samples with and without UTI.