Emerging Technologies for the Diagnosis of Urinary Tract Infections: Advances in Molecular Detection and Resistance Profiling
Baimakhanova B. Sadanov A. Berezin V. Baimakhanova G. Trenozhnikova L. Orasymbet S. Seitimova G. Kalmakhanov S. Xetayeva G. Shynykul Z. Seidakhmetova A. Turgumbayeva A.
October 2025Multidisciplinary Digital Publishing Institute (MDPI)
Diagnostics
2025#15Issue 19
Background/Objectives: Urinary tract infections (UTIs) represent a considerable challenge within the field of clinical medicine, as they are responsible for significant morbidity and intensify the operational pressures encountered by healthcare systems. Conventional diagnostic approaches, which include symptom evaluation, dipstick urinalysis, and standard urine culture, often demonstrate inadequacies in identifying atypical clinical manifestations, infections with low bacterial counts, or pathogens that show growth difficulties under typical laboratory conditions. These limitations undermine diagnostic accuracy and hinder timely therapeutic measures. Methods: The present manuscript is a systematic review conducted in accordance with PRISMA guidelines. A structured search was performed in PubMed, Scopus, and Google Scholar, yielding 573 records, of which 107 studies were included for qualitative synthesis. The primary aim of this systematic review is to evaluate both conventional and emerging diagnostic methods for UTIs, with specific objectives of assessing their clinical applicability, limitations, and potential to improve patient outcomes. Results: Recent progress in diagnostic technologies offers promising alternatives. Molecular-based assays, such as multiplex polymerase chain reaction, matrix-assisted laser desorption ionization mass spectrometry, and next-generation sequencing, have substantially improved both the precision and efficiency of pathogen identification. Furthermore, contemporary techniques for evaluating antimicrobial susceptibility, including microfluidic systems and real-time phenotypic resistance assays, enable clinicians to execute targeted therapeutic strategies with enhanced efficacy. Results of this synthesis indicate that while conventional diagnostics remain the cornerstone for uncomplicated cases, innovative molecular and phenotypic approaches demonstrate superior performance in detecting low-count bacteriuria, atypical pathogens, and resistance determinants, particularly in complicated and recurrent infections. These innovations support antimicrobial stewardship by reducing dependence on empirical antibiotic treatment and lessening the risk of resistance emergence. Conclusions: Nonetheless, the incorporation of these technologies into clinical practice requires careful consideration of implementation costs, standardization protocols, and the necessary training of healthcare professionals. In conclusion, this systematic review highlights that emerging molecular diagnostics and resistance-profiling tools offer substantial promise in complementing or enhancing traditional methods, but their widespread adoption will depend on robust validation, cost-effectiveness, and integration into clinical workflows.
antimicrobial susceptibility testing , diagnostic microbiology , molecular diagnostics , next-generation sequencing , urinary tract infection , urine culture , urobiome
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Research and Production Center for Microbiology and Virology LLC, Bogenbay Batyr St. 105, Almaty, 050010, Kazakhstan
Faculty of Chemistry and Chemical Technology, Al-Farabi Kazakh National University, Almaty, 480012, Kazakhstan
Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty, 050040, Kazakhstan
Departament of Pediatric Infectious Diseases, S.D. Asfendiyarov Kazakh National Medical University, Almaty, 050012, Kazakhstan
Department of Emergency Medicine and Nursing, Faculty of Medicine, JSC “South Kazakhstan Medical Academy”, Al-Farabi Square 1, Shymkent, 160001, Kazakhstan
Research and Production Center for Microbiology and Virology LLC
Faculty of Chemistry and Chemical Technology
Faculty of Medicine and Health Care
Departament of Pediatric Infectious Diseases
Department of Emergency Medicine and Nursing
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