Hypothesis / aims of study
Current UK guidelines require urine analysis before most urological surgeries to minimise iatrogenic
infections. However, the existing diagnostic pathway—relying on symptoms, dipstick tests, and Microscopy, Culture, and Sensitivity (MC&S)—is slow and unreliable, often taking multiple days and potentially missing clinically
significant infections. To improve patient outcomes and support antimicrobial stewardship, a faster,
more accurate test is essential. This study evaluated the Lodestar Dx, a rapid (35-minute) point-of-
care test designed to detect clinically relevant levels of the six most common UTI pathogens.
Study design, materials and methods
Eighty urine samples were collected from patients undergoing urology pre-operative assessment
(mean age 64; 57 male, 23 female). These samples were tested using the Lodestar DX system and the
results were compared against the simultaneous gold standard: standard urine microscopy, culture,
and sensitivity (MC&S), and dipstick urinalysis.
Interpretation of results
Crucially, the Lodestar test:
- Detected pathogen growth in 13 cases missed by MC&S.
- identified specific pathogens in 12 cases that MC&S reported as non-specific ''mixed growth''.
- Found positive growth in 20 out of 56 dipstick-negative samples (36%), including identifying
Pseudomonas and Enterococcus commonly missed non-nitrate converting organisms.
Concluding message
The Lodestar Dx showed strong potential as a rapid (35-minute), reliable alternative to standard
MC&S culture, offering improved accuracy for ruling out infection compared to the current gold
standard. By detecting several clinically relevant infections missed by MC&S and providing results
immediately, it enables a one-stop treatment decision. Overall, the Lodestar DX could significantly
enhance diagnostic efficiency, reduce surgical delays, and better support antimicrobial stewardship in
NHS pre-operative settings.