Department of Laboratory Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro Gangnam-gu, Seoul, 06273, South Korea.
Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea.
Sci Rep. 2021 Mar 16;11(1):6033. doi: 10.1038/s41598-021-85404-1.
To investigate the association between the results of urinalysis and those of concurrent urine cultures, and to construct a prediction model for the results of urine culture. A total of 42,713 patients were included in this study. Patients were divided into two independent groups including training and test datasets. A novel prediction algorithm, designated the UTOPIA value, was constructed with the training dataset, based on an association between the results of urinalysis and those of concurrent urine culture. The diagnostic performance of the UTOPIA value was validated with the test dataset. Six variables were selected for the equation of the UTOPIA value: age of higher UTI risk [odds ratio (OR), 2.069125], female (OR, 1.400648), nitrite (per 1 grade; OR, 3.765457), leukocyte esterase (per 1 grade; OR, 1.701586), the number of WBCs (per 1 × 10/L; OR, 1.000121), and the number of bacteria (per 1 × 10/L; OR, 1.004195). The UTOPIA value exhibited an area under the curve value of 0.837 when validated with the independent test dataset. The UTOPIA value displayed good diagnostic performance for predicting urine culture results, which would help to reduce unnecessary culture. Different cutoffs can be used according to the clinical indication.
为了研究尿分析结果与同期尿液培养结果之间的关联，并构建尿液培养结果的预测模型，本研究共纳入了 42713 名患者。患者被分为两个独立的数据集，即训练集和测试集。基于尿分析结果与同期尿液培养结果之间的关联，利用训练数据集构建了一种新的预测算法，命名为 UTOPIA 值。利用测试数据集验证了 UTOPIA 值的诊断性能。为 UTOPIA 值的方程选择了 6 个变量：较高 UTI 风险的年龄[比值比（OR），2.069125]、女性（OR，1.400648）、亚硝酸盐（每 1 级；OR，3.765457）、白细胞酯酶（每 1 级；OR，1.701586）、白细胞数（每 1×10/L；OR，1.000121）和细菌数（每 1×10/L；OR，1.004195）。在利用独立测试数据集进行验证时，UTOPIA 值的曲线下面积值为 0.837。UTOPIA 值对预测尿液培养结果具有良好的诊断性能，有助于减少不必要的培养。可以根据临床指征使用不同的截断值。
