Performance of Automatic Urine Analyzer Compared with Manual Microscopy in Urinary Tract Infection Cases in a Tertiary Care Hospital

Abstract

 Objectives: This study aimed to assess and compare the results of automated urine analyzers and manual urine analysis in the evaluation of urinary tract infections (UTIs) at Pakistan Navy Shifa Hospital Karachi.

Study Design and Setting: A cross-sectional study was conducted from March 2022 to December 2022 in the Microbiology Department of Pakistan Navy Shifa Hospital Karachi.

Methodology: Urine samples were randomly selected, and both automated urine analyzers (Urised, 77 Electronika, Hungary) and manual analysis methods were used for evaluation. Key urine parameters, including red blood cells, epithelial cells, leukocytes and crystals, were analyzed. Statistical analysis was performed using the Chi-square test with p-value less than .05. Sensitivity, specificity, PPV. And NPV were also determined.

Results: A total of 169 urine samples were analyzed. Significant differences were observed between the automated and manual methods for leukocytes (P-value < 0.000). Crystals were determined by both methods, automatic analyzer was unable to describe structure and morphology as compare to manual method.

Conclusions: Automated urine analyzers are essential for efficient and large-scale sample processing and standardization. However, further development is needed to improve the accuracy of identifying certain urinary elements. Manual microscopic examination remains crucial for confirming pathological cases. In high-volume settings like Pakistan, automated systems offer significant time-saving benefits but should be complemented with manual analysis for comprehensive diagnosis