Document Type

Conference Proceeding

Publication Date

2-2021

Abstract

Introduction: The two main challenges during the COVID 19 pandemic were to keep essential employees safe and to provide timely care to patients. We devised a novel urine specimen home pickup strategy for our patients with hematuria, irritative voiding symptoms as well as bladder cancer to address these issues. Methods: An employee dropped off necessary equipment for the urine sample to symptomatic patients’ houses. A clean catch specimen was collected and the sample left at the front door. The driver wearing PPE picked up the sample within 30 minutes and delivered it to the lab. Dipstick analysis was performed. Patients with leukocyte esterase or nitrate positive urine had a PCR culture. For patients who had hematuria with no previous cytology, a urine cytology and a PCR urine culture was ordered. Patients with a history of bladder cancer had cytology and FISH done. Urinalysis results were immediately sent to the physician via electronic medical records and a follow-up telemedicine appointment was scheduled. A retrospective analysis was performed for 2206 samples collected: 1122 (79.5% positive) from the office as controls and 1084 (82.7% positive) collected at home. Average turnaround time (TAT) was 1.96 days with average transit time of 0.70 days. TATs were faster for samples collected at home for both parameters. Results: 1148 patients were diagnosed with a clinically significant bacterial (>105 colonies) or yeast infection, (53.5% of office samples and 50.6% of home samples). A significant number of infections were caused by bacteria including Pseudomonas, Klebsiella, Proteus and E. Coli. Klebsiella pneumoniae, Streptococcus agalactiae, and Aerococcus urinae were significantly more common in home speciments than office specimens. Yeast infections with Candida Glabarata was found more often in home samples (p = 0.0153). Viral microbes were detected at the same rate, regardless of collection location. Nine of 74 (12%) FISH tests and 26 of 611 (4%) cytologies were abnormal leading to additional work up. Conclusion: Symptomatic urology patients were able to receive impactful healthcare while remaining sheltered in place during Covid 19 via our novel mobile care approach.

Comments

The Annual Winter Meeting of the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction, Virtual, February 25-27, 2021.

Also presented at the 96th Annual Meeting of the North Central Section of the American Urological Association; 2022 Aug 28-31; Chicago IL.

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