Pezzlo M
Department of Pathology, University of California Irvine Medical Center, Orange 92668.
Clin Microbiol Rev. 1988 Jul;1(3):268-80. doi: 10.1128/CMR.1.3.268.
A review of rapid urine screens for detection of bacteriuria and pyuria demonstrates a number of available alternatives to the culture method. Selection of one or more of these systems for routine use is dependent upon the laboratory and the patient population being tested. The laboratory approach to the diagnosis of urinary tract infection should consider the clinical diagnosis of the patient whenever possible. Keeping in mind that quantitative urine cultures alone cannot be used to detect infection in some patient populations unless lower colony counts are considered, a rapid screen may be a more practical approach. It has become accepted that 10(5) CFU/ml can no longer be used as the standard for all patient groups, that pyuria often is important in making the diagnosis of a urinary tract infection, and that most of the rapid screens are more sensitive than the culture method at 10(5) CFU/ml. Presently, no one approach can be recommended for all laboratories and all patient groups. However, each diagnostic laboratory should select one approach which is best for its situation. It is not practical, efficient, or cost effective to define a protocol for each possible clinical condition; however, all should be considered when developing a protocol. This protocol should be compatible with the patient population and communicated to the physicians. Use of a rapid screen should be beneficial to the patient, the physician, and the laboratory.
对用于检测菌尿和脓尿的快速尿液筛查的综述表明，有许多可替代培养方法的选择。选择一种或多种此类系统用于常规检测取决于实验室和所检测的患者群体。实验室对尿路感染的诊断方法应尽可能考虑患者的临床诊断。要记住，仅定量尿培养在某些患者群体中不能用于检测感染，除非考虑较低的菌落计数，快速筛查可能是一种更实用的方法。人们已经接受，10⁵CFU/ml不能再作为所有患者群体的标准，脓尿在尿路感染的诊断中通常很重要，并且大多数快速筛查在10⁵CFU/ml时比培养方法更敏感。目前，无法为所有实验室和所有患者群体推荐一种方法。然而，每个诊断实验室应选择一种最适合其情况的方法。为每种可能的临床情况定义一个方案既不实际、也无效率且不具成本效益；然而，在制定方案时应考虑所有情况。该方案应与患者群体相适应并传达给医生。使用快速筛查应对患者、医生和实验室都有益。
