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The use of light to diagnose infections of the lower urinary tract: A pilot study in children

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By: Armita Shadgan

This is a summary of a research paper by Dr. Babak Shadgan who is a clinical biophotonics research scientist working at the ICORD NeuroUrology Lab of Dr. Mark Nigro.

Original article: Shadgan B, et al., Optical diagnosis of lower urinary tract infection: A pilot study in children, Journal of Pediatric Urology (2015). Find the article here 

Introduction

Lower urinary tract infection (LUTI) is typically diagnosed using a patient’s medical history and the microscopic analysis of urine. This is a lengthy process, taking about 48-72 hours for results to be determined. Furthermore, this method is not always the most efficient, especially when it comes to children and in cases where a full history and the details of symptoms cannot be obtained. In this study, researchers sought to determine whether measuring the concentration of oxygen in the bladder wall with the use of Near Infrared Spectroscopy (NIRS, the use of near infrared light to detect levels of oxygen in tissue) could determine the presence or absence of this infection in children, instead of the typical and more time consuming methods of diagnosis.

How was this study carried out?

A sample of children with LUTI at a pediatric urology clinic and a group without infection (control group) were studied. The diagnosis of LUTI in the participants was confirmed using their history, physical examinations, and microscopic observations of their urine. Using a NIRS device, the average amount of oxygenation in the bladder wall and quadriceps tissues was then compared between those with LUTI and the control group.

What were the results?

Thirty-four patients were included; 12 had LUTI and the other 22 were in the control group. Comparing the bladder tissue oxygenation of both groups, values were much higher in the LUTI group, whereas the quadriceps oxygenation values were not significantly different. The numeric value of a cut off point for the diagnosis of the infection was also established. Using the NIRS device, patient preparation and data collection took under 3.5 minutes!

What does it all mean?

The use of NIRS was successful in detecting the presence of LUTI.

This method is non-invasive, meaning the device is simply placed on the skin over the bladder to measure the amount of near infrared light absorbed into the tissue.

Pros of using this method include the opportunity for the device to be used at the patient’s home with data sent through a secure wireless link to a urology clinic to be analyzed, as well as the diagnosis of post-surgical infections.

The use of NIRS to detect LUTI is much more time-efficient, particularly when diagnosing children, patients with spinal cord injury, and in other cases where a full patient history and symptom details can’t be obtained.

Although more clinical trials using a larger sample size are needed to confirm the results of this pilot study, this device could provide a faster and more efficient method of infection diagnosis. Needless to say, these are exciting findings that show the development possibilities of medical technology today.