Department of Laboratory Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
Ann Lab Med. 2019 May;39(3):322-326. doi: 10.3343/alm.2019.39.3.322.
We investigated the usefulness of age-specific cutoffs for screening of urinary tract infections (UTIs) in Korean outpatients, using the automated urine analyzer UF-1000i (Sysmex, Kobe, Japan). We retrospectively reviewed outpatient medical records. Urine samples of 7,443 outpatients from January 2010 to December 2017 were analyzed using urine culture and UF-1000i. ROC curves were calculated for each UF-1000i parameter based on the culture results. There were 1,398 culture positive samples, 5,774 culture negative samples, and 271 contaminated samples. UF-1000i had an area under the curve of ≥0.9 in outpatients >15 years. The appropriate cutoffs, which are the sum of bacterial (B-A-C) and white blood cell (WBC) counts, were 297.10/μL (15-24 years), 395.65/μL (25-44 years), 135.65/μL (45-64 years), 67.95/μL (65-74 years), and 96.5/μL (≥75 years). B-A-C and WBC counts differed among the three most frequently identified bacteria (, , and ). The UF-1000i system is useful for applying age-specific cutoffs to screen for UTIs, thereby preventing antibiotic abuse and reducing antibiotic resistance. Future studies can explore how its B-A-C and WBC counts can facilitate selection of empirical antibiotics by distinguishing between gram-positive and gram-negative bacteria.
我们使用自动尿液分析仪 UF-1000i(Sysmex,神户,日本)调查了特定年龄截断值在韩国门诊患者尿路感染(UTI)筛查中的有用性。我们回顾性地审查了门诊病历。使用尿液培养和 UF-1000i 分析了 2010 年 1 月至 2017 年 12 月的 7443 例门诊患者的尿液样本。根据培养结果计算了每个 UF-1000i 参数的 ROC 曲线。共有 1398 个培养阳性样本、5774 个培养阴性样本和 271 个污染样本。UF-1000i 在>15 岁的门诊患者中曲线下面积≥0.9。适当的截断值,即细菌(B-A-C)和白细胞(WBC)计数的总和,分别为 297.10/μL(15-24 岁)、395.65/μL(25-44 岁)、135.65/μL(45-64 岁)、67.95/μL(65-74 岁)和 96.5/μL(≥75 岁)。三种最常见鉴定细菌(,,和)之间的 B-A-C 和 WBC 计数存在差异。UF-1000i 系统有助于应用特定年龄截断值来筛查 UTI,从而防止抗生素滥用和减少抗生素耐药性。未来的研究可以探讨其 B-A-C 和 WBC 计数如何通过区分革兰氏阳性和革兰氏阴性细菌来帮助选择经验性抗生素。