{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T11:28:10Z","timestamp":1793618890643,"version":"4.5.0"},"reference-count":19,"publisher":"Walter de Gruyter GmbH","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,11,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_cclm-2026-0684_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Peritonitis is a feared complication to peritoneal dialysis (PD), requiring empirical broad-spectrum antibiotics. A rapid method to predict culture positivity and bacterial Gram classification could enable earlier targeted therapy and reduce unnecessary antibiotic exposure. This study evaluated the diagnostic performance of the automated flow cytometer Sysmex UF-5000 for cell counts and Gram classification in suspected PD-related peritonitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2026-0684_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adults (&gt;18 years) with suspected PD-associated peritonitis admitted to Aarhus University Hospital were included. Peritoneal dialysis fluid (PDF) was analysed using the UF-5000. Cell counts, bacterial counts, and Gram classification were compared with culture results. White blood cell (WBC) counts were additionally compared with Sysmex XN-9000.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2026-0684_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-two episodes in 39 patients were analysed; 71\u202f% were culture-positive. Bacterial and WBC counts on the UF-5000 were strongly correlated. WBC count in urine mode was the only parameter significantly associated with culture positivity (AUC 0.79), but several culture-negative cases had high WBC and bacterial counts. Gram classification was unreliable with 65\u202f% of culture-positive samples unclassified and 31\u202f% of the remainder misclassified. Agreement between the UF and XN WBC counts in body fluid mode was good (bias 7.6\u202f%), whereas UF urine mode showed substantial negative bias for both WBC and bacterial counts compared with body fluid\u00a0mode.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2026-0684_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>WBC count was the best predictor of culture positivity. Gram classification by UF-5000 urine mode was unreliable in PDF. The body fluid mode on the UF or XN is recommended for PDF analysis due to apparent interference in UF urine\u00a0mode.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/cclm-2026-0684","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T02:55:42Z","timestamp":1783997742000},"page":"2815-2822","source":"Crossref","is-referenced-by-count":0,"title":["Flow cytometric analysis of peritoneal dialysis fluid in suspected peritonitis: diagnostic performance and limitations"],"prefix":"10.1515","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4642-3079","authenticated-orcid":false,"given":"Lea","family":"Tybirk","sequence":"first","affiliation":[{"name":"Department of Clinical Biochemistry , Aarhus University Hospital , Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helle Pilgaard","family":"Kristiansen","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry , Aarhus University Hospital , Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mie","family":"Samson","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry , Aarhus University Hospital , Aarhus , Denmark"},{"name":"Department of Clinical Medicine , Aarhus University , Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinah Sherzad","family":"Khatir","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine , Aarhus University , Aarhus , Denmark"},{"name":"Department of Renal Medicine , Aarhus University Hospital , Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Winther-Larsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry , Aarhus University Hospital , Aarhus , Denmark"},{"name":"Department of Clinical Medicine , Aarhus University , Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"2026110211032906880_j_cclm-2026-0684_ref_001","doi-asserted-by":"crossref","unstructured":"Li, PK-T, Chow, KM, Cho, Y, Fan, S, Figueiredo, AE, Harris, T, et al.. ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment. Perit Dial Int 2022;42:110\u201353. https:\/\/doi.org\/10.1177\/08968608221080586.","DOI":"10.1177\/08968608221080586"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_002","doi-asserted-by":"crossref","unstructured":"Nochaiwong, S, Noppakun, K, Sood, MM, Thavorn, K, Knoll, GA, Ruengorn, C, et al.. Association between peritoneal dialysis-associated peritonitis and the risk of all-cause mortality and cardiovascular death: a time-matched retrospective cohort study. Med Sci 2025;13. https:\/\/doi.org\/10.3390\/medsci13040249.","DOI":"10.3390\/medsci13040249"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_003","doi-asserted-by":"crossref","unstructured":"Ye, H, Zhou, Q, Fan, L, Guo, Q, Mao, H, Huang, F, et al.. The impact of peritoneal dialysis-related peritonitis on mortality in peritoneal dialysis patients. BMC Nephrol 2017;18:186. https:\/\/doi.org\/10.1186\/s12882-017-0588-4.","DOI":"10.1186\/s12882-017-0588-4"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_004","doi-asserted-by":"crossref","unstructured":"Al Sahlawi, M, Bargman, JM, Perl, J. Peritoneal dialysis-associated peritonitis: suggestions for management and mistakes to avoid. Kidney Med 2020;2:467\u201375. https:\/\/doi.org\/10.1016\/j.xkme.2020.04.010.","DOI":"10.1016\/j.xkme.2020.04.010"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_005","unstructured":"CLSI. Body fluid analysis for cellular composition; approved guideline. Wayne, PA: Clinical and Laboratory Standards Institute; 2006."},{"key":"2026110211032906880_j_cclm-2026-0684_ref_006","doi-asserted-by":"crossref","unstructured":"Alcaide Mart\u00edn, MJ, Altimira Queral, L, Sahuquillo Fr\u00edas, L, Vali\u00f1a Amado, L, Merino, A, Garc\u00eda de Guadiana-Romualdo, L. Automated cell count in body fluids: a review. Adv Lab Med 2021;2:149\u201377. https:\/\/doi.org\/10.1515\/almed-2021-0011.","DOI":"10.1515\/almed-2021-0011"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_007","doi-asserted-by":"crossref","unstructured":"Yang, SS, Yang, CC, Chen, YS, Chang, SJ. A performance comparison of the fully automated urine particle analyzer UF-5000 with UF-1000i and Gram staining in predicting bacterial growth patterns in women with uncomplicated urinary tract infections. BMC Urol 2021;21:24. https:\/\/doi.org\/10.1186\/s12894-021-00791-x.","DOI":"10.1186\/s12894-021-00791-x"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_008","doi-asserted-by":"crossref","unstructured":"De Rosa, R, Grosso, S, Lorenzi, G, Bruschetta, G, Camporese, A. Evaluation of the new Sysmex UF-5000 fluorescence flow cytometry analyser for ruling out bacterial urinary tract infection and for prediction of Gram negative bacteria in urine cultures. Clin Chim Acta 2018;484:171\u20138. https:\/\/doi.org\/10.1016\/j.cca.2018.05.047.","DOI":"10.1016\/j.cca.2018.05.047"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_009","doi-asserted-by":"crossref","unstructured":"Penders, J, Fiers, T, Dhondt, AM, Claeys, G, Delanghe, JR. Automated flow cytometry analysis of peritoneal dialysis fluid. Nephrol Dial Transplant 2004;19:463\u20138. https:\/\/doi.org\/10.1093\/ndt\/gfg552.","DOI":"10.1093\/ndt\/gfg552"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_010","doi-asserted-by":"crossref","unstructured":"Rubio, E, Zboromyrska, Y, Bosch, J, Fernandez-Pittol, MJ, Fidalgo, BI, Fasanella, A, et al.. Evaluation of flow cytometry for the detection of bacteria in biological fluids. PLoS One 2019;14:e0220307. https:\/\/doi.org\/10.1371\/journal.pone.0220307.","DOI":"10.1371\/journal.pone.0220307"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_011","doi-asserted-by":"crossref","unstructured":"Baran, E, Ilki, AA. Evaluation of Sysmex-UF 5000-BF module for sterile body fluids. An alternative for conventional methods? Clin Lab 2023;69.","DOI":"10.7754\/Clin.Lab.2022.220522"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_012","doi-asserted-by":"crossref","unstructured":"Siatkowski, M, Dahyot, S, Pestel-Caron, M, Boyer, S. Performance evaluation of UF-4000 body fluid mode for detection of bacteria in body fluids. Clin Chim Acta 2023;538:9\u201314. https:\/\/doi.org\/10.1016\/j.cca.2022.10.020.","DOI":"10.1016\/j.cca.2022.10.020"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_013","doi-asserted-by":"crossref","unstructured":"Dossou, N, Gaubert, I, Moriceau, C, Cornet, E, le Hello, S, Malandain, D. Evaluation of flow cytometry for cell count and detection of bacteria in biological fluids. Microbiol Spectr 2022;10:e0183021. https:\/\/doi.org\/10.1128\/spectrum.01830-21.","DOI":"10.1128\/spectrum.01830-21"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_014","doi-asserted-by":"crossref","unstructured":"Andersen, ES, Brasen, CL, Christensen, AF, \u00d8stergaard, C, Brandslund, I. Carryover issues with UF-5000 urine flow cytometry\u00a0\u2013\u00a0how did we miss it? Clin Chem Lab Med 2020;58:e120\u20132. https:\/\/doi.org\/10.1515\/cclm-2019-0990.","DOI":"10.1515\/cclm-2019-0990"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_015","doi-asserted-by":"crossref","unstructured":"Haugum, K, Haugan, MS, Skage, J, Tetik, M, Jakovljev, A, Nilsen, HS, et al.. Use of Sysmex UF-5000 flow cytometry in rapid diagnosis of urinary tract infection and the importance of validating carryover rates against bacterial count cut-off. J\u00a0Med Microbiol 2021;70. https:\/\/doi.org\/10.1099\/jmm.0.001472.","DOI":"10.1099\/jmm.0.001472"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_016","doi-asserted-by":"crossref","unstructured":"Youden, WJ. Index for rating diagnostic tests. Cancer 1950;3:32\u20135. https:\/\/doi.org\/10.1002\/1097-0142(1950)3:1<32::aid-cncr2820030106>3.0.co;2-3.","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_017","doi-asserted-by":"crossref","unstructured":"Siatkowski, M, Dahyot, S, Pestel-Caron, M, Boyer, S. Performance evaluation of UF-4000 body fluid mode for automated body fluid cell counting. Clin Chim Acta 2022;531:152\u20136. https:\/\/doi.org\/10.1016\/j.cca.2022.04.002.","DOI":"10.1016\/j.cca.2022.04.002"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_018","doi-asserted-by":"crossref","unstructured":"Cho, J, Oh, J, Lee, SG, Lee, YH, Song, J, Kim, JH. Performance evaluation of body fluid cellular analysis using the beckman coulter UniCel D\u00d7H 800, Sysmex XN-350, and UF-5000 automated cellular analyzers. Ann Lab Med 2020;40:122\u201330. https:\/\/doi.org\/10.3343\/alm.2020.40.2.122.","DOI":"10.3343\/alm.2020.40.2.122"},{"key":"2026110211032906880_j_cclm-2026-0684_ref_019","doi-asserted-by":"crossref","unstructured":"Yang, W, Yu, X, Liu, D, Guan, X. High false positive rate of white blood cells in urine samples of pregnant women may be caused by epithelial cells being misclassified by the Sysmex UF-1000i urine flow cytometer. 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