用于菌尿筛查的快速生物发光法

Rapid bioluminescence method for bacteriuria screening.

作者信息

Pezzlo M T, Ige V, Woolard A P, Peterson E M, de la Maza L M

机构信息

Department of Pathology, University of California Irvine Medical Center, Orange 92668.

出版信息

J Clin Microbiol. 1989 Apr;27(4):716-20. doi: 10.1128/jcm.27.4.716-720.1989.

DOI:10.1128/jcm.27.4.716-720.1989

PMID:2656743

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC267403/

Abstract

A study was performed to evaluate the UTIscreen (Los Alamos Diagnostics, Los Alamos, N. Mex.), a rapid bioluminescence bacteriuria screen. The UTIscreen was compared with three other rapid bacteriuria screens: the Bac-T-Screen (Vitek Systems, Hazelwood, Mo.), an automated filtration device; the Chemstrip LN (Boehringer Mannheim Diagnostics, BioDynamics, Indianapolis, Ind.), an enzyme dipstick; and the Gram stain. A semiquantitative plate culture was used as the reference method. Of the 1,000 specimens tested, 276 had colony counts of greater than 10(5) CFU/ml by the culture method. Of these, the UTIscreen detected 96% (265 of 276) using greater than or equal to 5% of the integrated light output of the standard reading as a positive interpretive breakpoint, the Bac-T-Screen detected 96% (266 of 276), the Chemstrip LN detected 90% (249 of 276), and the Gram stain detected 96% (264 of 276). Of the 214 probable pathogens isolated at greater than 10(5) CFU/ml, the UTIscreen detected 95% (204 of 214), the Bac-T-Screen detected 98% (210 of 214), the Chemstrip LN detected 92% (198 of 214), and the Gram stain detected 98% (209 of 214). The predictive values of negative test results at greater than 10(5) CFU/ml for the UTIscreen, the Bac-T-Screen, the Chemstrip LN, and the Gram stain were 98, 97, 93, and 98%, respectively. The overall specificities at greater than 10(5) CFU/ml for the UTIscreen, the Bac-T-Screen, the Chemstrip LN, and the Gram stain were 70, 48, 51, and 69%, respectively. There were 532 specimens with colony counts of >10(3) CFU/ml, and of these, the UTIscreen, the Bac-T-Screen, the Chemstrip LN, and the Gram stain detected 72, 81, 76, and 73%, respectively. Of the 249 probable pathogens isolated at >10(3) CFU/ml, the UTIscreen, the Bac-T-Screen, the Chemstrip LN, and the Gram stain detected 91, 95, 89, and 93%, respectively. The overall specificities at > 10(3) CFU/ml for these methods were 79, 55, 57, and 78%, respectively. The cost per test for detection was approximately $0.50 for the Chemstrip LN. Overall, the UTIscreen is rapid and easy to perform; its sensitivity compared favorably with those of the other screening methods; it had higher specificity than the Bac-T-Screen and Chemstrip LN; and it allowed for bathing of specimen.

摘要

开展了一项研究以评估UTIscreen（洛斯阿拉莫斯诊断公司，新墨西哥州洛斯阿拉莫斯），一种快速生物发光菌尿筛查方法。将UTIscreen与其他三种快速菌尿筛查方法进行比较：Bac-T-Screen（维泰克系统公司，密苏里州黑兹尔伍德），一种自动过滤装置；Chemstrip LN（勃林格殷格翰诊断公司，生物动力学部，印第安纳州印第安纳波利斯），一种酶试纸条；以及革兰氏染色法。采用半定量平板培养作为参考方法。在检测的1000份标本中，通过培养法有276份标本的菌落计数大于10⁵CFU/ml。其中，UTIscreen以标准读数的积分光输出大于或等于5%作为阳性判读界值，检测出96%（276份中的265份），Bac-T-Screen检测出96%（276份中的266份），Chemstrip LN检测出90%（276份中的249份），革兰氏染色法检测出96%（276份中的264份）。在菌落计数大于10⁵CFU/ml时分离出的214种可能病原体中，UTIscreen检测出95%（214份中的204份），Bac-T-Screen检测出98%（214份中的210份），Chemstrip LN检测出92%（214份中的198份），革兰氏染色法检测出98%（214份中的209份）。UTIscreen、Bac-T-Screen、Chemstrip LN和革兰氏染色法在菌落计数大于10⁵CFU/ml时阴性检测结果的预测值分别为98%、97%、93%和98%。UTIscreen、Bac-T-Screen、Chemstrip LN和革兰氏染色法在菌落计数大于10⁵CFU/ml时的总体特异性分别为70%、48%、51%和69%。有532份标本的菌落计数>10³CFU/ml，其中UTIscreen、Bac-T-Screen、Chemstrip LN和革兰氏染色法分别检测出72%、81%、76%和73%。在菌落计数>10³CFU/ml时分离出的249种可能病原体中，UTIscreen、Bac-T-Screen、Chemstrip LN和革兰氏染色法分别检测出91%、95%、89%和93%。这些方法在菌落计数>10³CFU/ml时的总体特异性分别为79%、55%、57%和78%。Chemstrip LN每次检测的成本约为0.50美元。总体而言，UTIscreen操作快速且简便；其敏感性与其他筛查方法相比具有优势；它比Bac-T-Screen和Chemstrip LN具有更高的特异性；并且它允许对标本进行预处理。