Pfaller M, Ringenberg B, Rames L, Hegeman J, Koontz F
Diagn Microbiol Infect Dis. 1987 Mar;6(3):207-15. doi: 10.1016/0732-8893(87)90014-9.
A prospective study was conducted to examine the usefulness of screening tests for pyuria in combination with culture in the diagnosis of urinary tract infection (UTI) in outpatients. Midstream urine specimens were collected from 340 patients seen in the emergency treatment center (ETC) and were examined for pyuria using the chamber count method and the Leukocyte Esterase Dipstick test (LE; Bio Dynamics, Indianapolis, IN). All specimens were cultured quantitatively using both 0.01 ml and 0.001 ml calibrated bacteriologic loops. A total of 100 UTIs, defined by combined clinical and laboratory critera, were identified. Sixty-four (64%) infections were identified by culture using the standard interpretive breakpoint of greater than or equal to 10(5) CFU/ml and an additional 36 (36%) were detected using the low-count interpretive breakpoint of greater than or equal to 10(3) CFU/ml. We found pyuria detection by either the chamber count method or the LE test to be extremely useful in directing subsequent culture efforts. By using either of the tests for pyuria to determine the significance of low-count bacteriuria (10(3) - less than 10(5) CFU/ml) we were able to achieve maximum sensitivity (92%-99%) and specificity (99.2-99.6%) for the diagnosis of UTI while minimizing the number of specimens in which low numbers of organisms must be evaluated.
进行了一项前瞻性研究，以检验脓尿筛查试验与培养相结合在门诊患者尿路感染（UTI）诊断中的作用。从急诊治疗中心（ETC）的340名患者中采集了中段尿标本，并使用计数池法和白细胞酯酶试纸试验（LE；Bio Dynamics，印第安纳波利斯，印第安纳州）检测脓尿。所有标本均使用0.01 ml和0.001 ml校准细菌学接种环进行定量培养。根据临床和实验室综合标准，共鉴定出100例UTI。使用大于或等于10⁵CFU/ml的标准解释断点通过培养鉴定出64例（64%）感染，另外36例（36%）使用大于或等于10³CFU/ml的低计数解释断点检测到。我们发现，通过计数池法或LE试验检测脓尿对于指导后续培养工作极为有用。通过使用这两种脓尿检测试验之一来确定低计数菌尿（10³ - 小于10⁵CFU/ml）的意义，我们能够在诊断UTI时实现最大敏感性（92%-99%）和特异性（99.2-99.6%），同时将必须评估少量微生物的标本数量降至最低。
