Diagnosis of Urinary Tract Infections by Urine Flow Cytometry: Adjusted Cut-Off Values in Different Clinical Presentations

Table 5

Diagnostic performance of the in-house cut-offs and the sensitivity-optimized cut-offs for each clinical scenario.

Subgroup	Diagnostic performance using in-house cut-off (UFC /μL, UFC /μL)				Optimized cut-off corresponding diagnostic performance
	Sensitivity (%) (95% CI)	Specificity (%) (95% CI)	LR(+)	LR(-)	Cut-offs (/μL)		Sensitivity (%) (95% CI)	Specificity (%) (95% CI)	LR(+)	LR(-)
					Lc	Bact
Sex
Male ()	96.4 (87.5, 99.6)	60.6 (50.5, 70.0)	2.44	0.06	74	17	100 (93.5, 100)	54.8 (44.7, 64.6)	2.21	—
Female ()	98.6 (92.6, 100)	37.8 (26.8, 49.9)	1.59	0.04	169	103	97.3 (90.5, 99.7)	45.9 (34.3, 57.9)	1.8	0.06
Age
>65 ()	95.5 (87.5, 99.1)	58.7 (46.7, 69.9)	2.31	0.07	57	21	100 (94.6, 100)	50.7 (38.9, 62.4)	2.03	—
≤65 ()	100 (94.1, 100.0)	45.6 (35.8, 55.7)	1.84	—	169	103	96.7 (88.7, 99.6)	60.2 (50.1, 69.7)	2.43	0.05
Dysuria
Yes ()	100 (88.1, 100)	33.3 (16.5, 54.0)	1.5	—	205	103	96.6 (82.2, 99.9)	66.7 (46.0, 83.5)	2.90	0.05
No ()	97 (91.4, 99.4)	54.3 (46, 62.4)	2.12	0.06	74	21	100 (96.3, 100)	45.7 (37.6, 54)	1.84	—
Urinary frequency
Yes ()	100 (83.2, 100)	22.2 (6.4, 47.6)	1.29	—	108	210	100 (83.2, 100)	50.0 (26.0, 74.0)	2.00	—
No ()	97.2 (92.1, 99.4)	54.4 (46.3, 62.3)	2.13	0.05	74	21	100 (96.6, 100)	47.5 (39.6, 55.5)	1.90	—
Fever (>38.0°C)^1
Yes ()	97.2 (85.5, 99.9)	60.0 (46.5, 72.4)	2.43	0.05	108	14	100 (90.3, 100)	48.3 (35.2, 61.6)	1.94	—
No ()	97.8 (92.3, 99.7)	46.6 (37.4, 56.0)	1.83	0.05	171	22	96.7 (90.7, 99.3)	48.3 (39.0, 57.7)	1.87	0.07
UTI-specific abdominal pain^2
Yes ()	100 (89.1, 100)	34.6 (17.2, 55.7)	1.53	—	169	209	96.9 (83.8, 99.9)	53.8 (33.4, 73.4)	2.10	0.06
No ()	96.9 (91.1, 99.4)	53.9 (45.7, 62.1)	2.10	0.06	69	21	100 (96.2, 100)	47.4 (39.2, 55.6)	1.90	—
Diabetes
Yes ()	97.1 (84.7, 99.9)	57.5 (40.9, 73)	2.28	0.05	76	17	100 (89.7, 100)	50.0 (33.8, 66.2)	2.00	—
No ()	97.9 (92.5, 99.7)	49.3 (40.7, 57.9)	1.93	0.04	137	56	97.9 (92.5, 99.7)	55.8 (47.1, 64.2)	2.21	0.04
Renal insufficiency
Yes ()	95.1 (83.5, 99.4)	45.5 (32.0, 59.4)	1.74	0.11	74	21	100 (91.4, 100)	49.1 (35.4, 62.9)	2.00	—
No ()	98.9 (93.8, 100)	53.7 (44.4, 62.7)	2.13	0.02	108	54	97.7 (91.9, 99.7)	54.5 (45.2, 63.5)	2.15	0.04
Immunosuppression
Yes ()	100 (90.5, 100)	57.5 (45.4, 69.0)	2.35	—	74	24	97.3 (85.8, 99.9)	53.4 (41.4, 65.2)	2.09	0.05
No ()	96.7 (90.7, 99.3)	46.7 (36.9, 56.7)	1.81	0.07	151	21	97.8 (92.3, 99.7)	46.7 (36.9, 56.7)	1.83	0.05

¹One patient in the validation set did not have sufficient data to determine if °C. ²This includes lower abdominal, suprapubic, and flank pain. Abbreviations: Bact: UFC bacterium counts; CI: confidence interval; Lc: UFC leucocyte counts; LR: likelihood ratio; UFC: urine flow cytometry; UTI: urinary tract infection.