Aims: Urinary tract infection (UTI) is a common infection that can occur in inpatient and outpatient setting. The current guideline is using urine culture as standard for UTI diagnosis. Recently, urine flow cytometry method with dedicated bacterial channel is intended as useful tools for UTI diagnostic. In our study, we determine the cut-off value of white blood cell (WBC) and bacterial count of fluorescence flow cytometry as an estimation of the successful of urine culture in symptomatic UTI population. Methodology and results: The study was held from January until April 2015 at secondary and tertiary hospital in Bandung, Indonesia. A number of 215 UTI patients were enrolled. Urine specimens were analyzed using automated flow cytometry urine analyzer (UX2000, Sysmex Corp., Japan) and results were compared with urine culture, as gold standard. The cut-off value of WBC and bacterial count were determined using ROC to generate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). The combination of bacterial count ≥ 277.4 bacteria/uL, WBC count ≥ 300.7 cells/uL, in symptomatic UTI patients, achieved sensitivity of 82.7%, specificity of 87.5%, PPV of 96.6% and NPV of 53.8%. This combination can be use as estimation of positive culture as high as 96.6%. Conclusion, significance and impact of study: In microbiology aspect, quantitative bacterial count and WBC count of urine flow cytometry can be useful to estimate the success of culture-proven UTI, which can help in clinician decisionmaking and better patient management.
Urinary Tract Infections

Objectives: This study compared the epidemiological and clinical manifestations of patients hospitalized with respiratory syncytial virus (RSV) infection before and during the coronavirus disease 2019 (COVID-19) pandemic at a tertiary care hospital in Chiang Mai Province, Thailand. Methods: This retrospective observational study utilized data from all cases of laboratory-confirmed RSV infection at Maharaj Nakorn Chiang Mai Hospital from January 2016 to December 2021. Differences in the clinical presentation of RSV infection before (2016 to 2019) and during (2020 to 2021) the COVID-19 pandemic were analyzed and compared. Results: In total, 358 patients hospitalized with RSV infections were reported from January 2016 to December 2021. During the COVID-19 pandemic, only 74 cases of hospitalized RSV infection were reported. Compared to pre-pandemic levels, the clinical presentations of RSV infection showed statistically significant decreases in fever on admission (p=0.004), productive cough (p=0.004), sputum (p=0.003), nausea (p=0.03), cyanosis (p=0.004), pallor (p<0.001), diarrhea (p<0.001), and chest pain (p<0.001). Furthermore, vigilant measures to prevent the spread of COVID-19, including lockdowns, also interrupted the RSV season in Thailand from 2020 to 2021. Conclusions The incidence of RSV infection was affected by the COVID-19 pandemic in Chiang Mai Province, Thailand, which also changed the clinical presentation and seasonal pattern of RSV infection in children.