University of Ottawa, 451 Smyth Road, K1h 8M5 Ottawa, ON, Canada.
University of Ottawa, 451 Smyth Road, K1h 8M5 Ottawa, ON, Canada.
Appl Nurs Res. 2018 Feb;39:121-124. doi: 10.1016/j.apnr.2017.11.014. Epub 2017 Nov 6.
In clinical practice, patients provide samples that violate specimen collection guidelines. As no research exists to guide clinical practice for such situations involving sexually transmitted infections (STIs), we reviewed our clinical data to determine how to proceed when patients provided urine specimen >30mL. We tracked the quantity of urine, test outcomes, and whether or not patients returned to provide subsequent samples when notified to do so. Over 6months, 33 patients provided overfilled samples; we submitted 70% (n=23/33). From the submitted specimens, 5 infections were identified from 4 patients: all were positive for chlamydia and 1 for gonorrhea and chlamydia. This yielded the following positivity rates: 17.4% for chlamydia (n=4/23), and 4.3% for gonorrhea (n=1/23). For the group, the positivity rate was 17.4% (4 of 23 patients with infections), or 21.7% (5 infections from 23 patients). Lastly, only 60% of the patients instructed to return to clinic for retesting did so. Due to the possibility of false negative results, the ability to detect infections in overfilled samples, and because patients may not return for retesting, we recommend submitting overfilled samples, while also notifying patients to return to retest. This approach could maximize diagnostic rates, at least within STI testing clinics.
在临床实践中，患者提供的样本不符合标本采集指南。由于目前尚无研究针对涉及性传播感染（STI）的此类情况为临床实践提供指导，我们回顾了临床数据，以确定在患者提供超过 30 毫升尿液标本时应如何处理。我们跟踪了尿液量、检测结果，以及在通知患者再次提供样本时，他们是否返回。在 6 个月的时间里，有 33 名患者提供了过量的样本；我们提交了其中的 70%（23/33）。在提交的标本中，从 4 名患者中发现了 5 种感染：所有患者的衣原体检测均呈阳性，1 名患者的淋病和衣原体检测均呈阳性。这得出了以下阳性率：衣原体的阳性率为 17.4%（23 名感染患者中的 4 名），淋病的阳性率为 4.3%（23 名感染患者中的 1 名）。对于该组患者，阳性率为 17.4%（23 名感染患者中的 4 名），或 21.7%（23 名患者中的 5 种感染）。最后，只有 60%的患者按照指示返回诊所进行复查。由于存在假阴性结果的可能性、在过量样本中检测感染的能力，以及患者可能不会返回进行复查，因此我们建议提交过量的样本，同时通知患者返回复查。这种方法至少可以在 STI 检测诊所中提高诊断率。
