Yasuma Keiko, Nagao Miki, Matsumura Yasufumi, Matsushima Aki, Takakura Shunji, Adachi Minami, Higuchi Takeshi, Tanaka Michio, Ichiyama Satoshi
Department of Laboratory Medicine, Kyoto University Graduate School of Medicine/Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto 606-8507, Japan.
Rinsho Byori. 2012 Nov;60(11):1070-4.
Urine culture remains the gold standard for diagnosing urinary tract infections, but most clinical samples yield negative results. Fast screening methods will improve the turnaround time and also reduce the associated costs. We evaluated the detection of bacteria using the Sysmex UF-1000i urine analyzer to identify negative samples which do not need further culture testings. The bacterial counts of the UF-1000i method and of the conventional culture of 197 samples, including 117 samples of midstream urine (MU) and 80 from catheter ports (CU), were prospectively compared, and the patient backgrounds were reviewed. The cut-off values to determine the necessity for culture were 2.7 bacteria/microL for MU and 11.0 bacteria/microL for CU samples, and 16.2% of the MU and 30.0% of the CU samples did not require cultures. These cut-off values are similar to those described in previous studies, however, our findings suggest that it would therefore be possible to reduce the need for unnecessary samples by the use of our cut-off values, which utilize the CU and MU samples separately. The cost reduction was calculated to be $239-306 per 100 samples. This UF-1000i screening method is an acceptable modality which improves the turnaround time, workload and cost to perform urine cultures.
尿培养仍然是诊断尿路感染的金标准，但大多数临床样本结果为阴性。快速筛查方法将缩短周转时间并降低相关成本。我们评估了使用Sysmex UF - 1000i尿液分析仪检测细菌，以识别无需进一步培养检测的阴性样本。前瞻性地比较了197份样本（包括117份中段尿样本和80份导尿管端口样本）的UF - 1000i方法细菌计数与传统培养法细菌计数，并回顾了患者背景。确定培养必要性的临界值为中段尿样本每微升2.7个细菌，导尿管端口样本每微升11.0个细菌，16.2%的中段尿样本和30.0%的导尿管端口样本无需培养。这些临界值与先前研究中描述的相似，然而，我们的研究结果表明，通过使用我们分别针对导尿管端口样本和中段尿样本的临界值，有可能减少不必要样本的需求。经计算，每100份样本可降低成本239 - 306美元。这种UF - 1000i筛查方法是一种可接受的方式，可改善尿培养的周转时间、工作量和成本。
