Primary Contact:
Naomi Gitlin 
ngitlin@luc.edu

Loyola University Chicago Researchers Confirm Failures of Standard Urine Culture Test

Findings will help improve diagnosis and treatment of urinary tract infections, affecting more than 400 million people globally

MAYWOOD, IL – October 2, 2023

Research from physicians and scientists of the Loyola Urinary Education and Research Collaborative (LUEREC) at Loyola University Chicago shows that the standard urine culture test is inadequate, leading to under detection of many microbes and thus misdiagnoses.

“We have identified new evidence to support that the ‘gold standard’ in urine tests gives an incomplete and often flawed analysis of urine culture, leading to false negatives,” said Alan Wolfe, PhD, professor of Microbiology and Immunology, Stritch School of Medicine and co-director of LUEREC, a trans-disciplinary, translational research team of clinicians, clinical microbiologists, basic scientists, and bioinformaticians.    

In “Tarnished Gold,” a paper published this summer in Frontiers in Urology, Wolfe and the other authors call for the development of diagnostic tests to improve patient outcomes and potentially reduce antibiotic use for mis-diagnosed urinary tract infections (UTIs) and other disorders.  They conclude that standard culture methods under-report or fail to report most of the microbes found in the urinary tract – including some known and many emerging pathogens.

The authors call for development of better detection methods to improve diagnoses, improving patient care and reducing misuse of antibiotics. They call on clinicians to: 1). recognize the limitations of today’s tests, 2). consider multiple factors that could be causing symptoms that mimic UTIs and 3). Understand the likelihood of false negatives produced by the current “gold standard” in testing. 

“Our research shows that for patients with lower urinary tract symptoms, the standard urine sample test will not detect a majority of the microbes that comprise the urinary microbiome,” said Wolfe.

To address this problem, the LUEREC team created a more sensitive culture test that can identify most of the microbes that live in the bladder. This test has allowed them to accumulate more than 13,000 urinary isolates that includes hundreds of different microbial species.

In “Beyond the Usual Suspects,” another paper published this summer in Frontiers in Urology, Wolfe and his team use this collection to highlight a set of known and emerging uropathogens that are understudied. They argue that research should be directed towards understanding these microbes.

“Today, the prescribed treatment for urinary tract infections (UTIs) is based on an imperfect and partial view of all microbes,” said Wolfe.     

With substantial growth in the number of people diagnosed with UTIs (from 252.2 million in 1990 to more than 404.6 million in 2019 (according to the National Institutes of Health [NIH]), the LUEREC team’s findings will help researchers and clinicians continue to identify urinary microbes and develop better tests to identify and treat UTIs. 

These latest reports build upon LUEREC’s first publication 11 years ago (published in the Journal of Clinical Microbiology) that provided compelling evidence that the bladder is not sterile and showing that a healthy bladder has a unique community of microbes, called the urobiome.   

Improving patient outcomes often starts with examining and asking basic scientific questions.  In their earliest research, the LUEREC team contradicted a long-held belief purporting the bladder’s sterility. Now, understanding the presence of lesser known uropathogens can help identify risk factors for patients and improve therapeutic approaches. Looking at how these microbes interact with each other and the bladder will provide significant, foundational data points for further discovery. 

While research into understanding the urobiome is in its early stages, it has the potential to improve the evaluation and management of lower urinary tract disorders, including UTIs, overactive bladder, urgency urinary incontinence, and other conditions.

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About Loyola University Chicago  

Founded in 1870, Loyola University Chicago is one of the nation’s largest Jesuit, Catholic universities, with nearly 16,600 students. The University has four campuses: three in the greater Chicago area and one in Rome, Italy, as well as course locations in Vernon Hills, Illinois (Cuneo Mansion and Gardens), and a Retreat and Ecology Campus in Woodstock, Illinois. The University features 15 schools (including the Stritch School of Medicine), colleges, and institutes. Ranked a leading national university by U.S. News & World Report, Loyola is also among a select group of universities recognized for community service and engagement by prestigious national organizations including AmeriCorps and the Carnegie Foundation. To learn more about Loyola, visit LUC.edu or follow us on Twitter via @LoyolaChicago. Learn more about Stritch.