An answer in 35 minutes
A year of rapid UTI testing in Reading: what a dipstick misses, which bacteria we found, and how many patients did not need an antibiotic.
1 in 3
4 in 10
The three-day problem
Urinary tract infections are the most common bacterial infection treated by the NHS in England. Around seven million antibiotic prescriptions a year are written for them. Between a fifth and a third of sepsis cases begin in the urinary tract.
The tools for diagnosing them have barely changed. A dipstick gives an answer in minutes but is often wrong. A laboratory culture is more reliable but takes three to five days to come back, and it has blind spots of its own. It often misses infection in patients already taking antibiotics. When more than one bacterium is present it is frequently reported as “mixed growth” and set aside. In long-standing infection it can return clear results again and again. So most people are treated on symptoms alone. Every day of waiting is a day of guessing.
Time to a trustworthy answer
“We use it to decide whether to treat at all. That is the decision that has been made blind for decades.”
Prof Bob Yang, Consultant Urological Surgeon
What we did instead
Since July 2025 our urology team has used the Lodestar DX, a point-of-care molecular test made by Llusern Scientific in Cardiff and UKCA-marked for in vitro diagnostic use. It needs ten microlitres of urine and looks for the DNA of the six bacteria that cause the great majority of UTIs. The result comes back in the consulting room in 35 minutes, every time.
Knowing which bacterium is present lets us prescribe, there and then, the antibiotic best targeted to it. If the test is negative, the conversation turns to the causes of urinary symptoms that are not infection, and to treatments for those. The difference matters more than it sounds. Under the NHS Pharmacy First scheme, women with an uncomplicated UTI are usually given nitrofurantoin without any test. For E. coli that is the right choice about 98% of the time in Berkshire. For the other bacteria in the local antibiogram it is the wrong antibiotic in roughly one case in four.
- October 2025 to September 2026 · 631 tests
A year in numbers
Rapid tests run each month
Which bacteria we found
What it changed in the clinic
Of the 142 patients in the audit, 101 left with a different plan from the one they would have had on symptoms and a dipstick alone. For 55 of the 94 patients whose test was negative, that meant no antibiotic was needed. Seventeen moved to the MV140 vaccine, six to overactive bladder medication, six to cystoscopy, five to bladder instillation and two to Botox.
Half of the patients in the audit were tested before a procedure rather than because of symptoms. For them, the result meant something different: a negative test let the procedure go ahead that day, and a positive one meant treatment before it, without a week’s wait for a culture or a cancelled slot.
“For decades we have treated urinary infections on the strength of a dipstick we know is unreliable. Having a molecular answer while the patient is still in the room changes that. Four in ten of the patients in our audit left without an antibiotic, and those who did need one were treated for the organism we had actually found.”
ONE PATIENT’S STORY
“I had been on rounds and rounds of antibiotics and was still in pain, but the standard tests kept coming back clear. The Lodestar test was a gamechanger. It picked up the infection despite the medication already in my system. It is a huge relief to finally have proof of what I am feeling.”
Naomi, patient at The Forbury Clinic (Shared with consent.)
Why this matters beyond Reading
Every antibiotic given for an infection that isn’t there adds to resistance. In Berkshire, resistance to trimethoprim in E. coli, the commonest cause of UTI, has risen every year from 26.7% in 2023 to 28.9% in 2025. Nearly half of E. coli isolates are resistant to amoxicillin. The Nordic countries tightened prescribing years ago and the UK and EU have followed, in human and veterinary medicine alike. Better diagnostics are now accepted as central to better stewardship. What has been missing is a test fast enough to change the decision in the room.
Independent evaluation published in JAC-Antimicrobial Resistance in 2025 found a negative Lodestar DX result rules out infection with about 97% confidence. That is what makes it safe to withhold a prescription.
There is a second shift behind the numbers. Women are talking about their health more openly than ever and are asking for proper explanations of urinary symptoms rather than another course of tablets. Many of the patients in this report came to us after years of being treated on symptoms alone. Leaving an appointment with a result and a plan tailored to it is what they were looking for.
We are a small clinic. If our year is typical, the same approach across the country would spare hundreds of thousands of unnecessary courses of antibiotics a year.
The evidence
- Negative predictive value97.0%
- Specificity92.0%
- Sensitivity85.6%
- E.coli trimethoprim resistance, Berkshire 202528.9%
FROM THE MAKERS OF THE TEST
“Lodestar removes the guesswork from UTI diagnosis and, with a patient’s history and symptoms, gives clinicians a clearer understanding of their condition. Finding a partner with the mindset of wanting to change decades-old ways of working was crucial for the progress of our technology.”
Rapid UTI testing FAQs
Is a rapid UTI test as accurate as a culture?
Published evaluations show it detects the common UTI bacteria as reliably as laboratory culture, and a negative result is right about 97% of the time. Because it looks for bacterial DNA rather than waiting for bacteria to grow, it can also find infection in patients whose cultures have repeatedly come back clear despite classic symptoms, including those already on antibiotics.
Does it tell me which antibiotic I need?
It identifies the bacterium; the consultant uses that and local resistance data to choose the antibiotic there and then; a culture is sent where sensitivities matter.
Can I get this on the NHS?
Not routinely; the device is being evaluated in NHS settings including the Royal Berkshire Hospital.
Who should have one?
Anyone with urinary symptoms, people with recurrent infections, and patients being screened before or after a urological procedure.
