Next-generation point-of-care diagnostics for urinary tract infections: a systematic review of rapid pathogen detection methods

Background: Urinary tract infections are among the most prevalent bacterial infections worldwide, with Escherichia coli as the leading pathogen. Conventional diagnostic methods, including urine culture and antimicrobial susceptibility testing, require 48–72 hours, often delaying targeted therapy and promoting empirical antibiotic use, thereby exacerbating antimicrobial resistance. Objective: This review summarizes advances in point-of-care diagnostic technologies for rapid detection and antimicrobial susceptibility testing in localized or uncomplicated urinary tract infections. Methods: A comprehensive literature review of studies published between 2008 and 2025 was conducted using MeSH and free-text searches for “point-of-care testing”, “urinary tract infection”, “rapid diagnostics”, and related terms. Included studies described the mechanisms, performance, and clinical applicability of emerging point-of-care systems. Results: Thirty-four studies met inclusion criteria. Paper-based assays, lateral-flow tests, microfluidic devices, and hydrogel biosensors demonstrated rapid bacterial detection (from <5 min to 6 h) with variable sensitivities (10–106 CFU/mL). Among commercial devices, the Sysmex PA-100 antimicrobial susceptibility testing (AST) system provided phenotypic antimicrobial susceptibility testing within 30–45 minutes and achieved over 95% specificity compared with standard microbiology, while the Lodestar DX (LAMP-based) and Bosch Vivalytic (PCR-based) systems enabled molecular identification of uropathogens and resistance genes within 40–146 minutes. Conclusions: Point-of-care diagnostic platforms substantially reduce diagnostic turnaround, improve antibiotic stewardship, and offer cost-effective alternatives to conventional culture. The Sysmex PA-100 system currently represents the most clinically validated phenotypic point-of-care tool for uncomplicated urinary infections management. Future research should focus on expanding diagnostic panels, validating clinical outcomes, and facilitating integration into primary care and antimicrobial stewardship programs.