Evaluation of the Lodestar DX: A comparison with traditional culture for the detection of bacteriuria in the workup of urinary tract infection

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Drazich-Taylor, Stuart, Moore, James and McCann, Brian (2025) Evaluation of the Lodestar DX: A comparison with traditional culture for the detection of bacteriuria in the workup of urinary tract infection. JAC-Antimicrobial Resistance, 7 (4). ISSN 2632-1823

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Abstract

Background: The Lodestar DX is a point-of-care test (POCT) using loop-mediated isothermal amplification (LAMP) to detect common uropathogens. Novel POCTs may provide an adjunct in the diagnostic work up of urinary tract infection (UTI). Objectives To evaluate the performance of the Lodestar DX in the identification of bacteriuria. Methods: We compared the Lodestar DX against urine culture results from August to November 2024 at the Eastern Pathology Alliance in non-pregnant adults. Results: 379 urine samples were tested on the Lodestar DX. 344 (90%) of these passed both internal controls. Summary Lodestar DX performance was sensitivity 85.6% (95% CI 69.2%-94.6%), specificity 92.0% (95% CI 88.1%-94.9%), positive predictive value 64.1% (95% CI 48.7%-77.2%), negative predictive value 97.0% (95% CI 94.0%-98.6%) and overall accuracy 91.2% (95% CI 87.5%-94.0%). In cultures positive for their respective organisms, the sensitivity was 87.9% (n = 66, 95% CI 77.5%-94.6%) for Escherichia coli, 80% (n = 20, 95% CI 56.3%-94.3%) for Enterococcus, 27.3% (n = 11, 95% CI 6.0%-61%) for Staphylococcus aureus, 92.3% (n = 13, 95% CI 64.0%-99.8%) for Staphylococcus saprophyticus, 93.8% (n = 16, 95% CI 69.8%-99.8%) for Proteus mirabilis, 84.2% (n = 19, 95% CI 60.4%-96.6%) for Pseudomonas aeruginosa and 100% sensitivity (n = 2, 95% CI 15.8%-100%) for Klebsiella pneumoniae. Conclusions: In summary, the Lodestar DX had good performance for the detection of uropathogens apart from S. aureus. Further comparison with other POCTs would be beneficial.

Item Type:	Article
Additional Information:	Llusern Scientific provided the Lodestar DX and test kits at no cost for use during the study period. The study was also supported by internal funding.
Uncontrolled Keywords:	microbiology,immunology and allergy,immunology,microbiology (medical),infectious diseases,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2400/2404
Faculty \ School:	Faculty of Science > School of Biological Sciences Faculty of Medicine and Health Sciences > Norwich Medical School
Related URLs:	http://www.scopus.com/inward/record.url?...
Depositing User:	LivePure Connector
Date Deposited:	22 Aug 2025 15:30
Last Modified:	25 Aug 2025 00:29
URI:	https://ueaeprints.uea.ac.uk/id/eprint/100223
DOI:	10.1093/jacamr/dlaf128

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