Urinary Biochemical Alterations Associated with Uropathogenic Escherichia coli Infection: A Cross-Sectional Study at Al-Ramadi Hospital

Abstract

Background: The cross-sectional study investigated biochemical changes in urine of 200 patients with urinary tract infections at Al Ramadi Hospital to describe associated changes in case of uropathogenic Escherichia coli (UPEC) and measure diagnostic importance. Objectives: To describe associated changes in case of uropathogenic Escherichia coli (UPEC) and measure diagnostic importance. Materials and Methods: Participants were selected based on convenience sampling from patients aged 18 years or more who had not been treated with antibiotics within the past week. Urine analysis was performed for pH, specific gravity, protein, nitrite, and leucocyte esterase followed by urinalysis for presence of leucocytes, erythrocytes, bacteria, and epithelial cells. The urine culture followed by identification of pathogens based on standard methods and the VITEK 2 system was done. Results: Out of 200 patients, 82 (41.0%) were positive for Escherichia Coli. In comparison with UPEC-negative samples, UPEC-positive urine samples were characterized by increased values of pH (7.2 ± 0.8 versus 6.5 ± 0.9, p < 0.001), specific gravity (1.021 ± 0.007 versus 1.016 ± 0.009, p < 0.001), nitrite (68.3% versus 18.6%, p < 0.001), and leucocyte esterase (90.2% versus 69.5%, p < 0.001). Microscopy showed more cases with >10 WBCs/hpf (67.1% versus 31.3%, p < 0.001), many bacteria (39.0% versus 0.8%, p < 0.001), and red blood cells (41.5% versus 27.1%, p = 0.045) in UPEC-positive samples. Conclusion: The study implies that UPEC is associated with distinctive urine biochemical and microscopic changes.