Lipsky B A, Ireton R C, Fihn S D, Hackett R, Berger R E
J Infect Dis. 1987 May;155(5):847-54. doi: 10.1093/infdis/155.5.847.
Bacteriologic criteria for diagnosing urinary tract infections in men have not been well defined. For determination of the bacterial colony count in voided specimens that most accurately reflects bladder bacteriuria, culture results were compared for voided urine and bladder urine (obtained by suprapubic aspiration and urethral catheterization) from men with various genitourinary problems. Bladder bacteriuria was found in 36 (47.3%) of 76 sets of specimens from 66 individuals. Culture results of bladder specimens showed excellent agreement with those of clean-catch midstream-void and uncleansed first-void specimens (weighted kappa = 0.924 and 0.906, respectively). The criterion for clean-catch midstream-void specimens that best differentiated sterile from infected bladder urine was growth of greater than or equal to 10(3) cfu of one predominant species/ml; this definition had a sensitivity of 0.97 and a specificity of 0.97. Uncleansed first-void specimens were equally sensitive (0.97) but less specific (0.91-0.92) in detection of bacteriuria. Pyuria (greater than or equal to leukocytes/mm3) and irritative genitourinary symptoms showed modest correlations with bladder bacteriuria.
男性尿路感染的细菌学诊断标准尚未明确界定。为了确定最能准确反映膀胱菌尿的排尿标本中的细菌菌落计数，对患有各种泌尿生殖系统问题的男性的排尿尿液和膀胱尿液（通过耻骨上穿刺和尿道插管获取）的培养结果进行了比较。在来自66名个体的76组标本中，有36组（47.3%）发现了膀胱菌尿。膀胱标本的培养结果与清洁中段尿和未清洁首次排尿标本的培养结果显示出极好的一致性（加权kappa分别为0.924和0.906）。区分无菌与感染膀胱尿液的最佳清洁中段尿标本标准是每毫升一种优势菌的菌落形成单位大于或等于10(3)；该定义的敏感性为0.97，特异性为0.97。未清洁首次排尿标本在检测菌尿方面同样敏感（0.97），但特异性较低（0.91 - 0.92）。脓尿（白细胞大于或等于/mm3）和刺激性泌尿生殖系统症状与膀胱菌尿的相关性一般。
