Researchers at the Technical University of Munich (TUM) have developed a method for diagnosing urinary tract infections that significantly accelerates antibiotic resistance testing in urine. Because the procedure does not require labor-intensive pre-cultivation of bacteria - as is standard practice - results on antibiotic effectiveness are available one day earlier. Conventional laboratory analyses require two to three days. The new approach provides the foundation for a home-use rapid test.
Andreas Heddergott / TUM Approximately 152 million people are diagnosed with a urinary tract infection each year. This makes it one of the most common bacterial infections worldwide. In medical practices, urinary tract infections are typically diagnosed using a rapid urine test that detects elevated nitrite and leukocyte levels, both of which are indicators of infection. A broad-spectrum antibiotic is then often prescribed without determining the exact cause of the infection. Laboratory analysis is only carried out for high-risk patients and takes two to three days. The resulting incorrect or unnecessary prescription of antibiotics prolongs the treatment time, increases the risk of complications, and promotes the development of antibiotic resistance.
New method enables rapid resistance testing
Researchers at TUM have now developed two methods that allow urine samples to be tested directly for antibiotic susceptibility. Because the procedures do not require the standardized bacterial suspensions normally used in laboratory diagnostics, the time to result is reduced by up to 24 hours compared to conventional testing.
Henning Sabersky-Müssigbrodt / TUM Urine is applied directly to an agar plate onto which antibiotic disks have been placed. The diameter of the inhibition zones - areas where bacterial growth is suppressed by the antibiotic - is then measured. The key innovation of the new method is an algorithm that takes the actual bacterial concentration in the urine into account and adjusts its influence on inhibition zone size. As a result, resistance profiles can be determined reliably, even when urine is tested directly without prior standardization.
In parallel, the team is developing a paper-based point-of-care device that uses similar principles to identify eight different bacterial species via color changes and to indicate antibiotic resistance.
Targeted therapy instead of broad-spectrum antibiotics
"The sooner we know which antibiotic is effective, the more targeted our treatment can be," says Oliver Hayden, Heinz Nixdorf Professor of Biomedical Electronics. "This means we won't have to use broad-spectrum antibiotics as often, which should be used sparingly due to the development of resistance."
Initial data from the new test shows that it can compete well with the established method. In directly tested urine samples, the new test achieves a correlation of approximately 94 percent with the standard method. Researchers are using deviations from the reference method to further optimize the test, for example, in cases of very low bacterial concentrations or mixed infections.
"Our goal is a small, easy-to-use test that can be deployed in any medical practice with minimal effort and, in the future, also allows patients to test themselves at home using a paper-based device with results displayed on their smartphone. The technology is designed so that it can also be applied in low-resource settings, where rapid and reliable diagnostics are particularly critical." says Henning Sabersky-Müssigbrodt, first author of the study and doctoral researcher in Translational Medicine at the Heinz-Nixdorf Chair of Biomedical Electronics.
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Andreas Heddergott / TUM Sabersky-Müssigbrodt, H., Russell, S., Wantia, N., Hayden, O. Rapid direct disk diffusion testing for antibiotic resistance in urinary tract infections: a bacterial concentration-adjusted approach. Microbiology Spectrum (2025). https://doi.org/10.1128/spectrum.00888-25
- Behind the development of the test is the BugSense team. In 2023, the founders were awarded the m⁴ Award, having already won second place in the TUM IDEAward in 2021. In recent years, they have continuously advanced their concept and are now close to founding their spin-off.
- Video about the startup BugSense
- The Heinz-Nixdorf Chair of Biomedical Electronics at the TUM School of Computation, Information and Technology works with clinicians to develop in vitro and in vivo diagnostic methods at the Central Institute for Translational Cancer Research at TUM (TranslaTUM).
