This new test could transform UTI treatment with same-day results

Scientists at the University of Reading, working with researchers from the University of Southampton and Hampshire Hospitals NHS Foundation Trust, have developed a method that analyzes urine samples directly. On average, the test can determine which antibiotic will be effective in about 5.85 hours. Current lab methods typically take two to three days to provide the same information.

Study Shows High Accuracy for Fast UTI Testing

The research, funded by the National Institute for Health and Care Research (NIHR) and published March 31 in the Journal of Antimicrobial Chemotherapy, evaluated 352 urine samples from patients suspected of having UTIs. Results from the new test matched standard laboratory methods in 96.95% of cases across seven first line antibiotics used to treat UTIs.

A second analysis focused on 90 duplicate samples to determine whether storage conditions affected accuracy. Researchers compared samples collected with and without a preservative and found 98.75% agreement between results, showing that the preservative did not interfere with the test.

Dr. Oliver Hancox, Chief Executive Officer of Astratus Limited, the University of Reading spin-out company that will take the test to market, said: "By the time the laboratory delivers the result under current methods, a patient may already have finished their antibiotics, or been given ones that do not work.

"Being able to tell a doctor the same day which antibiotic to use means the patient gets the right treatment sooner, reducing the risk of resistance developing and their infection turning into potentially lethal sepsis."

Professor Mike Lewis, NIHR Scientific Director for Innovation, said: "This NIHR-funded research not only has the potential to deliver quicker, more effective treatments to patients suffering with UTIs -- but also tackles the broader challenge of antimicrobial resistance. The rapid urine test is a fantastic example of the real-world solutions to AMR that the government committed to developing in its 10-Year Health Plan."

Why Faster UTI Diagnosis Matters

According to NHS data, UTIs have resulted in more than 800,000 hospital admissions in England over the past five years. At the same time, about one in four urine samples tested in NHS laboratories contains bacteria that are resistant to commonly used antibiotics. In the UK alone, around 65 million urine samples are analyzed each year.

Under current procedures, urine samples must be cultured overnight so bacteria can grow before doctors can identify them and test antibiotics. This process adds significant delays, often taking two to three days in total.

How the Direct-from-Urine Test Works

The new method removes the need for overnight culturing and simplifies the testing process. A cartridge containing small tubes preloaded with different antibiotics is placed directly into the urine sample and inserted into an instrument.

The system then uses optical imaging to monitor bacterial growth in each tube. If bacteria stop growing, the antibiotic in that tube is effective. If growth continues, the drug is not suitable. This approach allows doctors to identify the correct treatment in less than six hours.

Professor Matthew Inada-Kim, a consultant acute physician and AMR Lead at Hampshire Hospitals NHS Foundation Trust, and researcher at the University of Southampton, said: "UTIs are a common reason that patients need antibiotics, and getting the right treatment first time could be a lifesaver.

"A test that works on samples we already collect as standard, and gives us answers the same day, is exactly the kind of tool that could change how we manage these infections in practice."

First-of-Its-Kind Study on Sample Preservation

To validate the approach, researchers used 352 urine samples that had already been collected during routine testing at Basingstoke and North Hampshire Hospital. They also conducted a separate experiment using 90 fresh samples from the emergency department.

Each of these samples was split into two, with boric acid added to one set to test whether the preservative would affect results. The findings showed 98.75% agreement, confirming that the preservative does not reduce accuracy. This is the first study to directly compare preserved and unpreserved urine samples using a rapid direct-from-urine testing method.

A Step Forward for Rapid Diagnostics

The results represent a key milestone for Astratus Limited, the University of Reading spin-out company established in November 2024 to bring the test to market.