Mortazavi Mojgan, Seyrafian Shiva, Shahidi Shahrzad, Abadpour Zahra, Shahbazi Foroud
Isfahan Kidney Diseases Research Center and Division of Nephrology, Department of Internal Medicine, Isfahan University of Medical Sciences, Iran.
Iran J Kidney Dis. 2011 Jan;5(1):50-2.
INTRODUCTION. This study was conducted to evaluate the sensitivity and specificity of pyuria detection in centrifuged urine samples of patients on hemodialysis, and its relationship with urinary tract infection. MATERIALS AND METHODS. Clean-catch midstream urine samples of 90 hemodialysis patients (34 women and 56 men) were obtained and divided into two parts for examination of urine sediment and urine culture. Pyuria was defined as the presence of more than 10 leukocytes per high-power field of microscope. RESULTS. Ninety patients with a mean age of 52.8 ± 14.2 and a mean period of dialysis of 3.3 ± 2.3 years were studied. Forty-five participants had pyuria and only 16 (35.5%) of them had a positive urine culture for infection. Pyuria and urinary tract infection were present in 52.9% and 29.4% of the women and 48.2% and 10.7% of the men, respectively. The sensitivity and specificity of pyuria screening for urinary tract infection was 100% and 61.8%, respectively. The positive and negative predictive values were 35.5% and 100%, respectively. CONCLUSIONS. In patients on hemodialysis, because of the low specificity and positive predictive values, samples with positive pyuria should be cultured to confirm urinary tract infections.
引言。本研究旨在评估血液透析患者离心尿液样本中脓尿检测的敏感性和特异性，及其与尿路感染的关系。材料与方法。获取90例血液透析患者（34名女性和56名男性）的清洁中段尿样本，并分为两部分用于尿沉渣检查和尿培养。脓尿定义为显微镜下每高倍视野白细胞超过10个。结果。研究了90例平均年龄为52.8±14.2岁、平均透析时间为3.3±2.3年的患者。45名参与者有脓尿，其中只有16例（35.5%）尿培养感染阳性。女性中脓尿和尿路感染的发生率分别为52.9%和29.4%，男性中分别为48.2%和10.7%。脓尿筛查尿路感染的敏感性和特异性分别为100%和61.8%。阳性和阴性预测值分别为35.5%和100%。结论。在血液透析患者中，由于特异性和阳性预测值较低，脓尿阳性的样本应进行培养以确诊尿路感染。
