Urinary Cytology: The DxU-850 Iris automaton versus Microscopic Examination

Abstract

INTRODUCTION: The use of urine cytobacteriological examination is a common and essential practice in medicine which helps guide therapeutic management in case of urinary tract infection. The cytological examination of urine samples can be done using the manual (microscopic) or automated technique. The automated approach, which involves the use of artificial intelligence, is faster, more reliable, and more efficient for laboratories. AIM: This work aims to evaluate the performance of the DxU-850 Iris automate by comparing it to the microscopic method. METHODS: Using a four-month prospective study from May to August 2023, we analyzed urine samples received during this period by the Microbiology laboratory of Mohammed VI University Hospital in Oujda. Strict quality standards were respected when obtaining the results. Several elements were analyzed, and various parameters calculated to evaluate the performance of this automaton. RESULTS: The present study investigated 1000 CBEU samples, mainly from outpatient clinics (46.34%) and emergency departments (21.72%). Most patients were males (50.58%) and asymptomatic (72.9%). The samples' culture showed varied results: concordance between the results of automaton and microscopic count was satisfactory except for crystals and yeasts in turbid samples. CONCLUSION: Automation has advantages like speed, traceability, error reduction, and time optimization. The results reveal a satisfactory concordance between the two methods despite discordances occurring mainly with crystals and yeasts, especially in turbid urine samples. The DxU-850 Iris automaton is an effective way to screen for urinary tract infections. We recommend that automated and manual techniques be considered complementary.