a Department of Internal Medicine/Infectious diseases , Isala , Zwolle , The Netherlands.
b Department of Clinical Chemistry , Isala , Zwolle , The Netherlands.
Infect Dis (Lond). 2017 May;49(5):380-387. doi: 10.1080/23744235.2016.1274048. Epub 2017 Jan 11.
The urine culture is worldwide accepted as the gold standard in diagnosing urinary tract infections, but is time consuming and costly, other methods are fast but moderately reliable. We investigated whether counting the number of bacteria by flow cytometry could be a fast and accurate method to analyze urine samples in febrile patients at the emergency department (ED).
Urine samples were obtained from 140 febrile patients at the ED. Urinalysis was performed according to standard procedures. Flow cytometric analysis for bacteria was performed with the Accuri C6 flow cytometer. Diagnostic values were determined at various cut-off points by using urine culture as the gold standard.
The highest diagnostic accuracy of urinalysis of bacteria was obtained with flow cytometric analysis (AUC of 0.96). The best cut-off value for bacteria counted by flow cytometry based on the ROC-curve was 3.72 × 10 bacteria/mL, this resulted in a sensitivity of 94.7% and a specificity of 88.2%.
Counting bacteria by flow cytometry has the highest diagnostic accuracy and is superior to other methods in urinalysis in febrile patients in the ED when using urine culture as the gold standard.
尿液培养被全世界公认为诊断尿路感染的金标准，但耗时且昂贵，其他方法快速但可靠性中等。我们研究了在急诊（ED）发热患者中，通过流式细胞术计数细菌数量是否可以成为一种快速而准确的分析尿液样本的方法。
从 ED 的 140 名发热患者中获得尿液样本。根据标准程序进行尿液分析。使用 Accuri C6 流式细胞仪进行细菌的流式细胞分析。通过将尿液培养作为金标准，在不同的截止值下确定诊断值。
细菌尿液分析的最高诊断准确性是通过流式细胞术分析获得的（AUC 为 0.96）。基于 ROC 曲线的最佳细菌计数截止值为 3.72×10 个细菌/ml，这导致敏感性为 94.7%，特异性为 88.2%。
当以尿液培养为金标准时，流式细胞术计数细菌的诊断准确性最高，在 ED 发热患者的尿液分析中优于其他方法。
