Christy Priskila, Sidjabat Hanna Evelina, Lumban Toruan Anggia Augustasia, Moses Emmanuel Jairaj, Mohd Yussof Narazah, Puspitasari Yessy, Fuadi Muhammad Robiul, Marpaung Ferdy Royland
Department of Clinical Pathology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo Hospital, Surabaya, East Java 60286, Indonesia.
Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.
Int J Nephrol. 2022 May 27;2022:9555121. doi: 10.1155/2022/9555121. eCollection 2022.
Rapid and reliable tests are essential for the diagnostic laboratory confirmation of urinary tract infections (UTIs). Until now, UTI has been confirmed by the microbiology culture of urine, requiring at least 48-hour turnaround time (TAT), with a standardized microscopic method being widely favored. Automated urine flow cytometry, however, has recently been used to improve the rapid TAT by analyzing the urine sediment. This study therefore aimed to compare the diagnostic value of the Shih-Yung conventional microscopic and urine flow cytometry methods in the detection of leukocyte and bacterial parameters of patients with UTIs in an outpatient clinic.
A cross-sectional study was conducted on a total of 100 patients. Seventy urine samples were positive for leukocytes and nitrite chemistry, and 30 were negative for both. The measurements of urine leukocytes and bacteria were compared between Sysmex UF-5000 urine flow cytometry and the Shih-Yung method. The diagnostic value was obtained from ROC analysis of urine flow cytometry and the culture.
A leukocyte cutoff value of 87.2/L had a sensitivity and specificity of 98.33% and 95%, respectively, and 98.33% sensitivity and 75% specificity at a bacterial cutoff of 582.22/L. Interestingly, our study identified strong and consistent agreement of leukocyte and bacterial parameters between urine flow cytometry and Shih-Yung ( = 0.959, < 0.001 and = 0.939, < 0.001, respectively). Furthermore, through analyzing the dominance angle of the scattergram, a strong agreement was obtained with the culture result ( = 0.880, < 0.001).
The Shih-Yung method showed consistent agreement with urine flow cytometry for the detection of leukocytes and bacteria. The use of certain cutoffs for bacterial and leukocyte parameters in urine flow cytometry demonstrated very good performance in detecting acquired symptomatic UTIs.
快速可靠的检测对于尿路感染（UTI）的诊断实验室确认至关重要。到目前为止，UTI一直通过尿液微生物培养来确认，这需要至少48小时的周转时间（TAT），标准化的显微镜检查方法受到广泛青睐。然而，最近自动尿液流式细胞术已被用于通过分析尿沉渣来缩短TAT。因此，本研究旨在比较施永传统显微镜检查和尿液流式细胞术方法在门诊UTI患者白细胞和细菌参数检测中的诊断价值。
对总共100名患者进行了横断面研究。70份尿液样本白细胞和亚硝酸盐化学检测呈阳性，30份两者均为阴性。比较了Sysmex UF-5000尿液流式细胞术和施永方法对尿液白细胞和细菌的测量结果。从尿液流式细胞术和培养的ROC分析中获得诊断价值。
白细胞临界值为87.2/L时，敏感性和特异性分别为98.33%和95%，细菌临界值为582.22/L时，敏感性为98.33%，特异性为75%。有趣的是，我们的研究发现尿液流式细胞术和施永方法在白细胞和细菌参数上有很强且一致的一致性（分别为=0.959，<0.001和=0.939，<0.001）。此外，通过分析散点图的优势角，与培养结果有很强的一致性（=0.880，<0.001）。
施永方法在检测白细胞和细菌方面与尿液流式细胞术显示出一致的一致性。在尿液流式细胞术中使用特定的细菌和白细胞参数临界值在检测获得性症状性UTI方面表现出非常好的性能。
