Kunz H H, Sieberth H G, Freiberg J, Pulverer G, Schneider F J
Dtsch Med Wochenschr. 1975 Oct 31;100(44):2252-6, 2261-4. doi: 10.1055/s-0028-1106531.
Urine obtained simultaneously by midstream voiding and supra-public bladder aspiration from 500 patients were compared by bacteriological and, in some, microscopic examination. In a second series a similar examination was undertaken on 1000 samples each, obtained by midstream voiding, catheterisation or suprapublic bladder aspiration from different patients. There was no significant difference in sediments or Stansfeld count between midstream and aspirated samples. Qualitative false-positive results for protein were obtained in 20% of midstream samples from women. The Kass count for significant bacteriuria was false-positive in 3.4% of midstream compared with bladder-aspiration samples, in 7.6% for "questionable bacteriuria". Positive counts of under 10(5)/ml were obtained in 41.3%, of under 10(4)/ml in 26.7% of aspirated samples. Counts under 10(4)/ml in midstream-voided samples are usually considered the result of contamination, at times falsely so. "Mixed infections" were 7.8 times more common in catheter and 11.4 to 11.8 times more common in midstream than in aspirated samples. The presence of microorganisms in suprapublic bladder aspiration is always abnormal. Chemotherapy is indicated only on results from bladder aspiration.
对500例患者通过清洁中段尿和耻骨上膀胱穿刺同时获取的尿液进行了细菌学比较,部分还进行了显微镜检查。在第二个系列中,对分别通过清洁中段尿、导尿或耻骨上膀胱穿刺从不同患者获取的各1000份样本进行了类似检查。中段尿样本和穿刺样本之间的沉淀物或斯坦斯菲尔德计数没有显著差异。女性清洁中段尿样本中有20%出现蛋白质定性假阳性结果。与膀胱穿刺样本相比,清洁中段尿样本中显著菌尿的卡斯计数假阳性率为3.4%,“可疑菌尿”为7.6%。穿刺样本中菌数低于10⁵/ml的占41.3%,低于10⁴/ml的占26.7%。清洁中段尿样本中菌数低于10⁴/ml通常被认为是污染所致,有时可能有误。“混合感染”在导尿样本中比穿刺样本多7.8倍,在清洁中段尿样本中比穿刺样本多11.4至11.8倍。耻骨上膀胱穿刺出现微生物总是异常的。化疗仅根据膀胱穿刺结果进行。