Concordance Between Sysmex UF-5000 Bacterial Flagging and Urine Culture Results for Differentiating Gram-Positive and Gram-Negative Bacteria

Ratna Agustina (Clinical Pathology Residency Education Program, Faculty of Medicine Universitas Udayana/Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar)
Anak Agung Wiradewi Lestari (Departement of Clinical Pathology, Faculty of Medicine Universitas Udayana/RS Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar)
I Nyoman Wande (Departement of Clinical Pathology, Faculty of Medicine Universitas Udayana/RS Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar)
Sianny Herawati (Departement of Clinical Pathology, Faculty of Medicine Universitas Udayana RS Ngoerah Hospital, Denpasar.)
Ni Nyoman Mahartini (Departement of Clinical Pathology, Faculty of Medicine Universitas Udayana/RS Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar)

Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Vol. 32 No. 3 (2026)

Urinary tract infections (UTIs) are among the most common infectious diseases globally, accounting for approximately 15% of all hospitalizations. Urine culture is considered the gold standard for diagnosing UTIs. However, this method requires specialized equipment and is time-consuming. In recent years, urine analysis by flow cytometry has begun to be used to detect bacteriuria quickly, accurately, and cost-effectively. The Sysmex UF-5000 uses flow cytometry to differentiate Gram-positive and Gram-negative bacteria, providing “BACT” flagging information. This analytical observational study with a cross-sectional design was conducted at the Integrated Laboratory of Ngoerah Hospital, Denpasar, from April to June 2023. Consecutive urine culture samples with sufficient volume (≥3 mL) were collected for urinalysis. The concordance between the Sysmex UF-5000 flagging and urine culture results was analyzed using Cohen's Kappa test. A total of 50 samples were analyzed. This study demonstrated agreement between the Sysmex UF-5000 flagging results and urine culture findings in differentiating Gram-positive and Gram-negative bacteria, with a Cohen's Kappa coefficient of 0.81. The Sysmex UF-5000 flagging shows excellent agreement or substantial concordance with urine culture results in differentiating Gram-positive and Gram-negative bacteria.