Center for General Practice, Aalborg University, Aalborg, Denmark.
Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark.
Scand J Prim Health Care. 2022 Mar;40(1):3-10. doi: 10.1080/02813432.2021.2022349. Epub 2022 Jan 13.
To describe the use and quality of point-of-care (POC) microscopy, urine culture and susceptibility testing performed in general practice in Northern Denmark from 2013 to 2018. Descriptive study General practices receiving a fee for examining urine samples. Simulated urine samples containing uropathogenic bacteria distributed by the organisation for improvement of microbiological quality (MIKAP). Percentage of use and correct answers for microscopy, culture and susceptibility testing. A total of 5361 samples were analysed by the use of microscopy (39.7%), culture (66.0%) and/or susceptibility testing (76.5%). For culture, Flexicult SSI urinary kit (87.6%) demonstrated the highest percentage of correct answers followed by chromogenic agar (85.1%) and 2-plate dipslide (85.2%). Mueller Hinton agar with tablets had the highest percentage of correct answers for susceptibility testing of most bacterial strains (84.6%), followed by Flexicult (77.2%). Furthermore, susceptibility testing with tablets (range: 76.1-84.6%) was found to be more accurate than discs (range: 72.9-75.5%). Overall, the highest percentage of correct answers was obtained when examining urine samples containing : Microscopy (78.3%), culture (87.0%) and susceptibility testing (range: 84.3-90.7%). The quality of POC testing in general practice was high when examining urine samples containing the most common uropathogen Surprisingly, susceptibility testing was more frequently used than culture. This approach may compromise the treatment decision as only cultures contribute with information about the flora composition and bacterial quantification. Interestingly, microscopy was the least used method even though the result may be reached within a few minutes.Key pointsThe quality of POC tests (microscopy, urine culture, susceptibility testing) performed in general practice was high when examining urine containing , whereas difficulties were observed for samples including or Susceptibility testing was more often performed than urine culture, which indicates a problem as only urine cultures contribute with information about the flora composition and bacterial quantification.
描述 2013 年至 2018 年期间丹麦北部普通实践中进行的即时护理（POC）显微镜检查、尿液培养和药敏试验的使用情况和质量。描述性研究 接受尿液样本检查费用的普通实践。由微生物质量改进组织（MIKAP）分发的含有尿路病原体的模拟尿液样本。显微镜检查、培养和药敏试验的使用百分比和正确答案。共分析了 5361 个样本，其中显微镜检查（39.7%）、培养（66.0%）和/或药敏试验（76.5%）。对于培养，Flexicult SSI 尿液试剂盒（87.6%）显示出最高的正确答案百分比，其次是显色琼脂（85.1%）和 2 板浸碟（85.2%）。对于大多数细菌菌株，Mueller Hinton 琼脂片的药敏试验具有最高的正确答案百分比（84.6%），其次是 Flexicult（77.2%）。此外，药敏试验片（范围：76.1-84.6%）比药敏试验片（范围：72.9-75.5%）更准确。总体而言，当检查含有：显微镜检查（78.3%）、培养（87.0%）和药敏试验（范围：84.3-90.7%）的尿液样本时，获得了最高的正确答案百分比。普通实践中 POC 检测的质量很高，当检查含有最常见的尿路病原体的尿液样本时 令人惊讶的是，药敏试验比培养更频繁地使用。由于只有培养物才能提供有关菌群组成和细菌定量的信息，因此这种方法可能会影响治疗决策。有趣的是，即使结果可以在几分钟内得出，显微镜检查仍然是使用最少的方法。要点 普通实践中进行的即时护理（POC）检测（显微镜检查、尿液培养、药敏试验）的质量在检查含有 的尿液时很高，而对于含有 或 的样本则存在困难。与尿液培养相比，药敏试验更常进行，这表明存在一个问题，因为只有尿液培养才能提供有关菌群组成和细菌定量的信息。
