U R I N E A N A LY S I S

A U T O M AT I O N MLS 419 Laboratory


Analysis of Urine and Body Fluids (Lab.)

San Pedro College

Bachelor of Science in Medical Laboratory Science
TOPIC
OUTLINE

• Introduction

• Semi-automated urine chemistry analyzers

• Fully-automated chemistry analyzers

• Automated urine cell analyzers

• Automated urine system

U R I N A LY S I S
A U T O M AT I O N

• Goal: Improved reproducibility and

color discrimination while increasing
productivity and standardization for
reporting urinalysis results.

• Standardize:
-sample processing
-analyze test strips
-perform urine sediment analysis
-report results
 U R I N A LY S I S
A U T O M AT I O N

• FEATURES

1. Online computer capability

2. Bar coding
3. Manual entry of color
4. Clarity
5. Microscopic results
6. Flagging of abnormal results
7. Storing of patients and control results
8. Minimal calibration
9. Cleaning
10. Maintenance
 U R I N A LY S I S
A U T O M AT I O N

• CLASSIFICATIONS
1. Semi-automated analyzers
2. Fully-automated chemistry
analyzers
3. Automated urine cell analyzers
4. Automated urine system
S E M I - A U T O M AT E D U R I N E C H E M I S T R Y
A N A LY Z E R S
S E M I - A U T O M AT E D U R I N E C H E M I S T R Y
A N A LY Z E R S

• Test for chemical components of urine

• Read and interpret the reagent strip

results

• Eliminates bias in reagent pad color

analysis and reading descripancies

• leukocyte, nitrite, protein, blood,

glucose, ketone, bilirubin,
urobilinogen, pH, specific gravity,
color, creatinine, and protein-to-
creatinine ratio
S E M I - A U T O M AT E D U R I N E C H E M I S T R Y
A N A LY Z E R S

• For small-medium volume

laboratories and physician’s offices

• Self-calibrating and perform

automatic checks (Auto-Checks)
-identify strip type and humidity
exposure

• Manually dipped> placed in strip

reader> analyzing the strip>
dispose strip in waste container
S E M I - A U T O M AT E D U R I N E C H E M I S T R Y
A N A LY Z E R S

• Patient identification, specimen color,

clarity — entered manually or
barcode reader

• Positive results are flagged —

requires confirmation testing or
microscopic evaluation

• Minimal daily maintenance—

cleaning reagent strip platform and
emptying reagent strip waste
container.
S E M I - A U T O M AT E D U R I N E C H E M I S T R Y
A N A LY Z E R S

Dip the reagent strip into a well-mixed urine

sample

Blot the strip to remove excess urine

Place the strip onto the reagent strip platform

Press the analyzer

S E M I - A U T O M AT E D U R I N E C H E M I S T R Y A N A LY Z E R S
F U L LY A U T O M AT E D
URINE CHEMISTRY
A N A LY Z E R S
F U L LY A U T O M AT E D U R I N E C H E M I S T R Y
A N A LY Z E R S

• High-volume urinalysis laboratory

• User “walk-away” capability

• Ability to load many samples with the

capability to insert a STAT specimen
during the run.

• Pressed the button to begin testing

and samples move automatically
through the instruments
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S EM
L LY
I - AAUUTTOOMMAT
ATEEDD UURRI N
I NEE CCHHEEMMI SI STTRRYY
A N A LY Z E R S

Specimen identification

Aspirates urine sample and dispenses 


directly onto reagent strip

Analyze by reflectance photometry

Dispose strip test automatically to waste box

F U L LY A U T O M AT E D U R I N E C H E M I S T R Y
A N A LY Z E R S

• leukocytes, ketones, protein,

glucose, nitrite, blood, urobilinogen,
pH, bilirubin, color, clarity, creatinine,
and protein.

• Color- reflectance photometry or

spectrophotometry

• Specific gravity- refractive index

methodology

• Clarity -transmitted or scattered light

F U L LY A U T O M AT E D U R I N E C H E M I S T R Y
A N A LY Z E R S

• Integrated bar-coded sample

identification

• Abnormal ranges to be selected—

microscopic examination or
confirmatory testing will be identified
and flagged.

• Patient results, quality control results,

calibrations — stored for visual
display, print- out, or transmission to
a laboratory computer system.
F U L LY A U T O M AT E D U R I N E C H E M I S T R Y A N A LY Z E R S
A U T O M AT E D
MICROSCOPY
A U T O M AT E D M I C R O S C O P Y

• Provide standardize results in less than 1

minute

• Cost-effective and improve turnaround

time

• Sysmex UF-1000i and iQ 200 (Iris

Diagnostics
A U T O M AT E D M I C R O S C O P Y
Sysmex UF 1000i

• laser-based flow cytometry

• forward light scatter, side scatter,

fluorescence staining characteristics, and
adaptive cluster analysis to identify stained
urine sediment particles

• 4 mL of uncentrifuged urine
A U T O M AT E D M I C R O S C O P Y
Sysmex UF 1000i

• 2 channels
1. urine particle analysis
2. bacteria staining and detection

• staining the internal components of the cells

• passes through the flow cell, where it is

hydrodynamically focused and presented to a
red semi- conductor laser (635 nm)

• Identified by measuring the height and width of

the fluorescent and light scatter signals, which
are presented in scattergrams and histograms.
A U T O M AT E D M I C R O S C O P Y
Sysmex UF 1000i

• The width of the fluorescent signal

measures cellular inclusions and the width
of forward light scatter measures the
length of cells

• Resulting values are presented in

quantitative cells per microliter and cells
per high- or low-powered field
A U T O M AT E D M I C R O S C O P Y
Sysmex UF 1000i

• red blood cells (RBCs), white blood cells

(WBCs), epithelial cells, hyaline casts, and
bacteria. The results are displayed as
scattergrams

• Flagged particles include pathologic casts,

crystals, small round cells (renal tubular
epithelial cells or transitional epithelial
cells), sperm, mucus, and yeast-like cells,
and must be confirmed by manual
microscopy.
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Sysmex UF 1000i
A U T O M AT E D M I C R O S C O P Y

iQ 200 Automated Urine Microscopy Analyzer

• Digital imaging and Auto-Particle Recognition

• Preclassify urine particles in uncentrifuged urine

based on size and shape

• Can be use also for body fluid cell counts—add

body fluids software module

• Mixes sample and aspirates approx. 1 mL of urine

to a planar flow cell

• 500 digital photomicroscopic images taken per

sample
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iQ 200 Automated Urine Microscopy Analyzer

• Strobe light passes through the collimator

in a single beam

• Specimen is surrounded by lamina —

orient the particles for microscopic viewing

• Digital video camera takes 500 pictures

• Digital images are sent to the computer

A U T O M AT E D M I C R O S C O P Y

iQ 200 Automated Urine Microscopy Analyzer

• Auto-Particle Recognition (APR) software

• preclassifies urine particles based on size,

shape, texture, and contrast into 12 categories:
RBCs, WBCs, WBC clumps, Hyaline casts,
unclassified casts, SECs, non SECs, bacteria,
yeast, crystals, mucus, and sperm.

• Results reviewed easily and reclassified by the

operator without the need for manual
microscopy.
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iQ 200 Automated Urine Microscopy Analyzer

• Subclassify 27 additional categories to

indicate the specific types of crystals, casts,
epithelial cells, yeast with pseudohyphae,
trichomonads, and oval fat bodies.
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sedMAX (77Elektronika)
• Performs automated microscopy with digital
imaging

• requires 2 mL of urine centrifuged in a special

cuvette to produce a monolayer of urine sediment

• Sediment is analyzed by a bright-field microscope

and digital camera

• categorize 15 particle images based upon size

and shape using image-processing software

• zoom capability to view images

A U T O M AT E D
U R I N A LY S I S
SYSTEMS
A U T O M AT E D U R I N A LY S I S S Y S T E M S

• Combination of urine chemistry analyzers

and automated urine cell analyzers

• Improved TAT and hands-on time will be

reduced

• complete walkaway capability with minimal

specimen handling from sampling through
results

• bar-coded samples are au- tomatically

identified and processed
A U T O M AT E D U R I N A LY S I S S Y S T E M S

• Can independently perform both physical

and chemical testing, microscopy analysis,
and a combination of both.

• A complete urinalysis report can be sent

directly to the LIS or printed out
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CLINITEK AUWi System (Siemens)

• The Clinitek Atlas (automated urine
chemistry analyzer) + Sysmex UF-1000i
(automated urine cell analyzer)
= CLINITEK AUWi System (Siemens)

• minimum of 5 mL of urine

• rack advances to the ATLAS analyzer,

(identified, mixed, aspirated, and tested
for physical and chemical components)

• Sample travels across a connecting bridge

to the UF-1000i for microscopic analysis.
 A U T O M AT E D U R I N A LY S I S S Y S T E M S

CLINITEK AUWi System (Siemens)

• The Clinitek Atlas (automated urine
chemistry analyzer) + Sysmex UF-1000i
(automated urine cell analyzer)
= CLINITEK AUWi System (Siemens)

• minimum of 5 mL of urine

• rack advances to the ATLAS analyzer,

(identified, mixed, aspirated, and tested
for physical and chemical components)

• Sample travels across a connecting bridge

to the UF-1000i for microscopic analysis.
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iRICELL Automated Urinalysis Systems

• minimum of 4 mL of urine is required

• bar-coded tubes are placed into the

10-position rack and moved to the
iChem VELOCITY (mixed and the urine
is aspirated)

• Upon completion of the physical and

chemical analysis, the rack moves
across the connecting bridge to the iQ
200 for microscopy testing