Winkens Ron, Nelissen-Arets Hanny, Stobberingh Ellen
Transmural Care Unit Department of Medical Microbiology, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
Fam Pract. 2003 Aug;20(4):410-2. doi: 10.1093/fampra/cmg412.
So far, the validity of urine dipslides has been studied only under optimal conditions, which may not reflect the situation in daily practice.
We studied the validity of the urine dipslide as performed under daily practice conditions and assessed the influence of the incubation period (24 h versus 48 h) on validity.
Fresh urine samples of patients with signs/symptoms of a possible urinary tract infection (UTI) were examined in general practice via a nitrite test, a urine sediment and a dipslide. A second dipslide was inoculated and sent to the hospital microbiology laboratory for culture. This culture acted as gold standard. We calculated the sensitivity and specificity of the tests performed.
Of the 273 patient episodes included, 62% had a UTI (166 of 268 cultures). The sensitivity of the dipslide performed in daily general practice was 73% and the specificity was 94%.
The validity of the dipslide read under practice conditions is lower than under optimal conditions. Actions to improve performance are needed. Nonetheless, using the dipslide instead of the sediment as a second step after the nitrite test would improve the diagnostic work-up of UTI.
迄今为止，尿液试纸条的有效性仅在最佳条件下进行过研究，而这些条件可能无法反映日常实践中的情况。
我们研究了在日常实践条件下尿液试纸条的有效性，并评估了培养时间（24小时与48小时）对有效性的影响。
在全科医疗中，对有疑似尿路感染（UTI）体征/症状患者的新鲜尿液样本进行亚硝酸盐试验、尿沉渣检查和试纸条检测。接种第二张试纸条并送至医院微生物实验室进行培养。该培养结果作为金标准。我们计算了所进行检测的敏感性和特异性。
在纳入的273例患者中，62%患有UTI（268份培养物中有166份）。在日常全科医疗中进行的试纸条检测敏感性为73%，特异性为94%。
在实际条件下读取的试纸条有效性低于最佳条件下的有效性。需要采取措施提高其性能。尽管如此，在亚硝酸盐试验后第二步使用试纸条而非尿沉渣将改善UTI的诊断检查。
