Q&A: Novel UTI detection method may help curb antibiotic overprescribing in primary care - Healio

A caller method of UTI detection designed specifically for usage successful superior attraction predicted with precocious accuracy erstwhile antibiotics could beryllium safely withheld from low-risk patients, according to researchers.

Daniel Parente, MD, PhD, FAAFP, an adjunct prof of household medicine and assemblage wellness and probe manager of the household medicine residency programme astatine the University of Kansas Medical Center, and colleagues wrote that UTI symptoms are communal successful superior care, but results from the notation modular trial for corruption — a urine civilization — instrumentality much than a day. These delays tin pb to antibiotic overprescribing, fueling ongoing concerns regarding antibiotic resistance.

To amended prescribing practices, the researchers redesigned a urine civilization prediction exemplary — the NeedMicro classifier — that antecedently demonstrated occurrence successful an ED mounting truthful that it could beryllium feasibly implemented successful superior care. To bash this, they removed urine microscopy features that are not often disposable successful superior attraction and recovered that removing these features “did not severely compromise show nether interior validation.”

Parente spoke with Healio astir the redesigned model, known arsenic the NoMicro classifier, however it compares to accepted UTI detection methods, the interaction it could person connected practices and more.

Healio: Can you concisely picture the NoMicro classifier?

Parente: The NoMicro classifier uses instrumentality learning to foretell whether patients attending a superior attraction assignment with symptoms of a urine corruption volition person a civilization that grows pathogenic bacteria. Without the NoMicro classifier, clinicians would person to hold for up to 24 hours to get civilization results, but decisions astir antibiotics are often made close away, earlier the cultures are available. We utilized information that had been antecedently published by a antithetic probe radical that built a urine civilization predictor for usage successful exigency departments. However, this classifier needed to person accusation astir urine microscopy — cells and bacteria seen nether the microscope — to marque predictions, which galore superior attraction offices cannot cheque astatine the constituent of care. NoMicro is antithetic successful that it avoids needing to usage accusation astir urine microscopy and relies connected lone accusation that superior attraction providers usually would person available.

Healio: How does it work? How effectual is it?

Parente: The NoMicro classifier is simply a instrumentality learning bundle program. It takes arsenic input accusation astir respective objective features, including demographics (age, gender), urine dipstick results (nitrites, leukocytes, blood, clarity, glucose, protein), symptoms (abdominal pain, urinary burning), and whether a diligent had urine infections successful the past. It uses this to cipher a numerical “score” that a urine civilization volition extremity up increasing pathogenic bacteria. The people gets compared to a “cutoff” number, which lets it person the people into a yes-or-no prediction of “likely pathogenic” oregon “likely not pathogenic.” By adjusting the cutoff, you tin tune instrumentality learning predictors to assistance with circumstantial objective situations. In our case, we were funny successful trying to trim antibiotic overuse. We wanted to beryllium definite that predictions of “likely not pathogenic” were precise reliable. After tuning our exemplary for this, it achieved a antagonistic predictive worth of 92.3%.

Healio: How does it comparison to accepted methods of UTI detection?

Parente: Machine learning-based methods are large improvements implicit accepted methods of UTI detection, similar relying connected conscionable urine dipstick information. Machine learning methods inactive request that accusation (urine dipstick) but tin besides announcement patterns successful symptoms and urine investigating that simpler methods conscionable cannot relationship for.

Healio: What benignant of interaction could this person connected the contented of antibiotic overprescribing and overuse?

Parente: We anticipation that the quality to foretell erstwhile cultures volition beryllium antagonistic (normal) mightiness let providers to reduce antibiotic overuse. We utilized humanities information to measure this potential. Physicians are already beauteous bully astatine deciding erstwhile patients request antibiotics — adjacent without the civilization results — but our information suggests they tin bash adjacent amended utilizing our method. However, we volition request to bash much enactment earlier clinicians tin safely usage our classifier connected existent patients. All of our enactment utilized humanities data. We volition request to execute prospective objective trials to marque definite that the benefits of reducing antibiotic overuse are not outweighed by immoderate risks.

Healio: What are the objective implications of your findings?

Parente: We inactive request to bash immoderate further objective investigating connected our algorithms earlier superior attraction doctors commencement routinely utilizing our predictor successful real-world practice. The astir important happening we request to bash is to marque definite that it is harmless to not prescribe antibiotics erstwhile the exemplary thinks a diligent is apt to person a mean culture. We deliberation it astir apt is safe, based connected the humanities information we utilized successful our study, but we tin lone beryllium definite erstwhile we bash a prospective objective trial. We anticipation that, if those objective trials spell well, that physicians volition beryllium capable to confidently usage our method to trim antibiotic overuse.

Healio: What is the take-home connection for superior attraction providers?

Parente: Artificial quality and instrumentality learning are rapidly expanding our quality to admit patterns successful analyzable situations. Primary attraction clinicians are apt to payment from this technological revolution. Our exertion of instrumentality learning to urine civilization prediction is conscionable 1 illustration of however this benignant of exertion tin beryllium utilized successful superior care.

Healio: Is determination thing other you’d similar to add?

Parente: We’d emotion to link with practicing physicians oregon researchers who are funny successful however artificial quality and instrumentality learning volition alteration the signifier of superior care.

References:

• Dhanda G, et al. Ann Fam Med. 2023;doi:10.1370/afm.2902.
• Taylor RA, et al. PLOS One. 2018;doi:10.1371/journal.pone.0194085.