Clin Lab. 2023 Apr 1;69(4). doi: 10.7754/Clin.Lab.2022.220522.
Infections of cerebrospinal fluid (CSF), peritoneal and pleural fluids often result in severe morbidity and mortality. Cytometric analysis, cell count, and cell differentiation is supportive in rapid clinical decision. The aim of this study is to evaluate the performance of Sysmex UF-5000 (Sysmex Co., Kobe, Japan) in body fluid (BF) mode for white blood cells and bacterial counting and compare the results with manual microscopy, gram staining, and culture as reference method.
A total of 634 body fluid samples (433 CSF, 100 pleural, and 101 peritoneal fluid) submitted to our clinical microbiology laboratory between December 2018 and January 2020 were enrolled in the study. Specimens were analyzed for white blood cell (WBC) counts with Sysmex UF-5000-BF mode. The results were grouped into five categories and compared with the conventional methods as reference method. The relationship between culture results and Sysmex UF5000-BF bacterial load and WBC count were evaluated for the detection of infection.
The categorical agreement of UF 5000-BF mode was very strong for CSF (correlation coefficient: 0.70, p < 0.05) and good agreement was found for pleural and peritoneal samples (correlation coefficient: 0.63, p < 0.05). Sensitivity was 100% and specificity was 64% in pleural samples. For ascites sensitivity and specificity were found as 94.1% and 77.4%, and for CAPD samples as 100% and 81,2% respectively. Bacterial and WBC count with flow cytometry was higher among culture positive samples (p < 0.05). The same significant difference was detected between the UF 5000-BF bacterial counts and the samples in which bacteria were detected in the gram preperation (p < 0.05). WBC count by UF-5000-BF was also higher among culture positive compared to culture negative samples (p < 0.05).
Our results demonstrated that the flow cytometric method, Sysmex UF-5000 body fluid (BF) mode, can be an alternative particularly in CSF samples. Detection of 100% sensitivity in peritoneal and pleural samples can prevent unnecessary antibiotic treatment and possible resistance development. Besides, automated bacterial counting can be used for rapid prediction of a positive body fluid culture.
脑脊液（CSF）、腹膜和胸腔液感染常导致严重的发病率和死亡率。流式细胞术分析、细胞计数和细胞分化有助于快速临床决策。本研究旨在评估 Sysmex UF-5000（Sysmex 公司，神户，日本）在体液（BF）模式下对白细胞和细菌计数的性能，并与手动显微镜、革兰氏染色和培养作为参考方法进行比较。
本研究共纳入 2018 年 12 月至 2020 年 1 月期间我院临床微生物实验室送检的 634 例体液样本（433 例 CSF、100 例胸腔液和 101 例腹腔液）。采用 Sysmex UF-5000-BF 模式分析白细胞（WBC）计数。结果分为五类，并与传统方法作为参考方法进行比较。评估培养结果与 Sysmex UF5000-BF 细菌负荷和 WBC 计数的关系，以检测感染。
UF5000-BF 模式对 CSF 的分类一致性非常强（相关系数：0.70，p<0.05），对胸腔液和腹腔液样本的一致性良好（相关系数：0.63，p<0.05）。胸腔液样本的敏感性为 100%，特异性为 64%。对于腹水，敏感性和特异性分别为 94.1%和 77.4%，对于 CAPD 样本，敏感性和特异性分别为 100%和 81.2%。流式细胞术细菌和 WBC 计数在培养阳性样本中较高（p<0.05）。UF5000-BF 细菌计数与革兰氏染色阳性样本之间也存在显著差异（p<0.05）。与培养阴性样本相比，UF-5000-BF 白细胞计数在培养阳性样本中也较高（p<0.05）。
我们的结果表明，流式细胞术方法，Sysmex UF-5000 体液（BF）模式，可以作为一种替代方法，特别是在 CSF 样本中。在腹膜和胸腔液样本中检测到 100%的敏感性可以防止不必要的抗生素治疗和可能的耐药性发展。此外，自动细菌计数可用于快速预测体液培养阳性。
