Lorentzon S, Hovelius B, Miörner H, Tendler M, Aberg A
Södertull Community Health Centre, Lund, Sweden.
Scand J Prim Health Care. 1990 Jul;8(2):81-3. doi: 10.3109/02813439008994935.
Three diagnostic tests, Nitur, Urobact, and Uricult, were evaluated in the detection of bacteriuria in 865 pregnant women. As reference method agar culture was performed. Heavy growth (greater than 10(5) CFU/ml) of urinary tract bacteria was considered a true positive result and demonstrated in 58 (6.7%) of the women, 14 of whom had gram-negative rods. The sensitivity of the nitrite test was extremely low (0.13). The test gave negative results in eight of 17 specimens yielding heavy growth of Escherichia coli or Proteus mirabilis. Although the Urobact test was highly sensitive as regards gram-negative infection, it had an unacceptably low (0.27) predictive value in positive tests. The sensitivity of the Uricult test was low (0.35) in this study. The predictive value (0.50) of a positive test result may be acceptable, since just over half of the false positive results were explainable by moderate growth of urinary tract pathogens (10(4)-10(5) CFU/ml). It is argued that semi-quantitative urine culture may be preferable to the rapid diagnostic methods studied for the screening of bacteriuria in pregnant women.
对865名孕妇进行了三项诊断试验，即Nitur、Urobact和Uricult，以检测菌尿症。采用琼脂培养作为参考方法。尿路细菌大量生长（大于10⁵CFU/ml）被视为真阳性结果，58名（6.7%）女性检测出该结果，其中14名女性的致病菌为革兰氏阴性杆菌。亚硝酸盐试验的敏感性极低（0.13）。在17份大肠杆菌或奇异变形杆菌大量生长的标本中，该试验有8份结果为阴性。尽管Urobact试验对革兰氏阴性菌感染高度敏感，但其阳性试验的预测值低得令人无法接受（0.27）。在本研究中，Uricult试验的敏感性较低（0.35）。阳性试验结果的预测值（0.50）可能是可以接受的，因为略超过一半的假阳性结果可由尿路病原体中度生长（10⁴ - 10⁵CFU/ml）解释。有人认为，对于孕妇菌尿症的筛查，半定量尿培养可能比所研究的快速诊断方法更可取。
