Lens free holographic imaging for urinary tract infection screening

Urinary tract infections (UTIs) are a common condition that can lead to serious complications including kidney injury, altered mental status, sepsis, and death. Laboratory tests such as urinalysis and urine culture are the mainstays of UTI diagnosis, whereby a urine specimen is collected and processed to reveal its cellular and chemical composition. This process requires precise specimen collection, handling infectious human waste, controlled urine storage, and timely transportation to modern laboratory equipment for analysis. Holographic lens free imaging (LFI) can measure large volumes of urine via a simple and compact optical setup, potentially enabling automatic urine analysis at the patient bedside. We introduce an LFI system capable of resolving important urine clinical biomarkers such as red blood cells, white blood cells, crystals, casts, and E. Coli in urine phantoms. This approach is sensitive to the particulate concentrations relevant for detecting several clinical urine abnormalities such as hematuria, pyuria, and bacteriuria. We show bacteria concentrations across eight orders of magnitude can be estimated by analyzing LFI measurements. LFI measurements of blood cell concentrations are relatively insensitive to changes in bacteria concentrations of over seven orders of magnitude. Lastly, LFI reveals clear differences between UTI-positive and UTI-negative urine from human patients. Together, these results show promise for LFI as a tool for urine screening, potentially offering early, point-of-care detection of UTI and other pathological processes.