Jennifer T. Anger, MD, MPH, presented “Point-Counterpoint: PCR and NGS is the New Standard for Clinical Evaluation, not Culture and Sensitivity – Pro” during the 30th Annual Perspectives in Urology: Point-Counterpoint, on March 10, 2023, at Humphreys Half Moon Inn, San Diego, California.
How to cite: Anger, Jennifer T. “Point-Counterpoint: PCR and NGS is the New Standard for Clinical Evaluation, not Culture and Sensitivity – Pro.” March 10, 2023. Accessed Nov 2024. https://grandroundsinurology.com/point-counterpoint-pcr-and-ngs-is-the-new-standard-for-clinical-evaluation-not-culture-and-sensitivity-pro/
Point-Counterpoint: PCR and NGS is the New Standard for Clinical Evaluation, not Culture and Sensitivity – Pro – Summary
Jennifer T. Anger, MD, MPH, makes the case that polymerase chain reaction (PCR) and next-generation sequencing (NGS) is the new standard for clinical evaluation of urinary tract infections (UTIs) in this Point-Counterpoint lecture. Dr. Anger explains that UTIs are caused by a dysbiosis of normal flora and asserts that culture doesn’t provide a complete picture and doesn’t help symptomatic patients on antibiotics who are culture-negative; she asserts NGS fills in the diagnostic gaps.
Dr. Anger addresses the utility of NGS in catheter-associated UTIS (CAUTIs), which make up ~80 percent of all UTIs. Dr. Anger presents data from a head-to-head comparative phase II study of standard urine culture and sensitivity versus DNA NGS testing for UTIs that showed 30 percent of DNA-positive samples were culture-positive; additionally, patients who were culture-negative and NGS-positive had improved outcomes when treatment was initiated based on NGS results. She addresses cost before turning to NGS studies at UCSD on interstitial cystitis (IC), fertility, stricture disease, and inflatable penile prosthesis (IPP) infections and using NGS to tailor antibiotics.
Dr. Anger concludes with four points: NGS offers a comprehensive scope of the urinary tract microbiome; has superior diagnostic ability compared with culture; informs improved tailoring of antibiotics; and has the potential to provide insights for certain conditions including stone disease, infertility, and IC.
This lecture is part of a Point-Counterpoint debate. Its opposing lecture is “Point-Counterpoint: PCR and NGS is the New Standard for Clinical Evaluation, not Culture and Sensitivity – Con.”
About the 30th Annual Perspectives in Urology: Point Counterpoint conference: Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.
ABOUT THE AUTHOR
Jennifer T. Anger, MD, MPH, (she/her) Professor of Urology; Vice Chair of Research; and The C. Lowell and JoEllen Parsons Endowed Chair in Urology, Gender Affirming Surgery, Urologic Reconstruction, and FPMRS with the University of California at San Diego Health System is a board-certified female pelvic medicine and reconstructive surgery expert who has dedicated her career to improving the quality of surgical care for patients with pelvic floor disorders. She is the only physician in San Diego who performs gender affirming pelvic or "bottom" surgery, including vaginoplasty (penile inversion, peritoneal and intestinal), vulvoplasty (zero or shallow depth), metoidioplasty, phalloplasty, and robotic hysterectomy with vaginectomy and non-binary options.
