**3. Urine specimen and antibiotic-resistant pathogens**

The emergence of the antimicrobial resistant pathogen is worldwide issue threatening thousands if not millions of lives every year and with more and more strains developing not only a single drug resistance but also multidrug resistance (MDR) making the treatment of the disease much more complicated. Furthermore, many pathogens have developed resistance against a second-line or even last resort drugs. Recently the emergence of colistin-resistant strains attracted a lot of attention. Some of these resistant pathogens can cause serious illness or even death.

Some *Mycobacterium tuberculosis* strains developed what is called extensively drugresistant (XDR), a rare form of MDR which shows resistance to at least one of the second-line drugs, isoniazid, rifampin, and fluoroquinolone [83, 84].

Enterobacteriaceae, the leading cause of UTIs, developed resistance to β-lactam antibiotics by producing β- Lactamases, rendering this class of antibiotic to a large extended ineffective [37]. As mentioned above, with the lack of new drug

#### **Figure 1.**

*Schematic demonstrating how antibiotics can contribute to the AMR crisis and how it can change the microbiome of the patient.*


#### *n size in the study population.*

#### **Table 1.**

*Resistance rates among 331* Escherichia coli *from urinary tract infection of women over 18 visiting a French GP in 2012–2013 [85].*

**195**

*Urine Tests for Diagnosis of Infectious Diseases and Antibiotic-Resistant Pathogens*

development and only few new drugs being in the production pipeline, UTIs with AMR are a major concern, and it is a leading cause of morbidity and a cause of significant financial loss in many countries. It is estimated that 50% of all women

The abuse and misuse of antimicrobial drugs are the leading causes of this worldwide issue. Controlling the prescription of antimicrobial drugs by practicing judicial drug prescription based on susceptibility testing is of paramount importance not only to control this fast-growing issue of AMR against currently used drugs in the market but to ensure lasting effectiveness of future treatment options and drugs. This cannot be achieved by the effort of the medical practitioner only, but it needs the active effort of policymakers, scientist, and the large community (**Figure 1**).

Urine specimen can play a major role in fighting against this crisis; urine cultures for the diagnosis of UTIs can be used for susceptibility testing, thus following antimicrobial stewardship program recommendation. Urine specimen has the potential to be used for the same reason in other infectious diseases where the pathogen can

Over the ages, urine proved to be an extremely valuable diagnostic specimen; today, it constitutes one of the most common samples processed in clinical and diagnostic laboratories. Its role in the diagnosis of a wide and diverse range of disorders cannot be argued against, ranging from drugs test and metabolic diseases identification to the diagnosis of STDs and lethal infectious disease. Its importance in antimicrobial resistance tests is also of great value, contributing to achieving the

With the advances in today's technologies, urinalysis now has great potentials, and the merging of test strip technologies with smartphone technologies can lead to tremendous changes in healthcare system and can deeply integrate point-of-care testing into the health system. Furthermore, advances in mass spectrometry can lead to great achievement not only in the diagnostic field by providing a much faster and accurate results, but it can also contribute greatly in the medical and biomedical research fields.

, Sanjay Doiphode2

2 Department of Laboratory Medicine and Pathology, Hamad Medical Corporation,

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

, Asma Al Thani1

*DOI: http://dx.doi.org/10.5772/intechopen.89231*

be found in urine (**Table 1**).

**4. Conclusion**

**Author details**

and Hadi Yassine1

Nahla O. Eltai1

Doha, Qatar

will suffer from UTI at some point in their lives.

antimicrobial stewardship program recommendations.

\*, Hashim Alhussain1

1 Biomedical Research Center, Qatar University, Doha, Qatar

\*Address all correspondence to: nahla.eltai@qu.edu.qa

provided the original work is properly cited.

#### *Urine Tests for Diagnosis of Infectious Diseases and Antibiotic-Resistant Pathogens DOI: http://dx.doi.org/10.5772/intechopen.89231*

development and only few new drugs being in the production pipeline, UTIs with AMR are a major concern, and it is a leading cause of morbidity and a cause of significant financial loss in many countries. It is estimated that 50% of all women will suffer from UTI at some point in their lives.

The abuse and misuse of antimicrobial drugs are the leading causes of this worldwide issue. Controlling the prescription of antimicrobial drugs by practicing judicial drug prescription based on susceptibility testing is of paramount importance not only to control this fast-growing issue of AMR against currently used drugs in the market but to ensure lasting effectiveness of future treatment options and drugs. This cannot be achieved by the effort of the medical practitioner only, but it needs the active effort of policymakers, scientist, and the large community (**Figure 1**).

Urine specimen can play a major role in fighting against this crisis; urine cultures for the diagnosis of UTIs can be used for susceptibility testing, thus following antimicrobial stewardship program recommendation. Urine specimen has the potential to be used for the same reason in other infectious diseases where the pathogen can be found in urine (**Table 1**).
