Clinical Laboratory, Children's Hospital Affiliated to Shandong University, Jinan, China.
Clinical Laboratory, Jinan Children's Hospital, Jinan, China.
PLoS One. 2024 Jun 12;19(6):e0304286. doi: 10.1371/journal.pone.0304286. eCollection 2024.
A rapid screening test for urinary tract infections (UTIs) in children is needed to avoid unnecessary cultures and provide prompt reports to make appropriate clinical decisions. We have evaluated for the first time the performance of the Sysmex UF-5000 flow cytometer as a screening tool for UTIs in children.
This study included 4445 pediatric patients, with urinary sediment and urine culture data collected from January 2020 to September 2023. The Sysmex UF-5000 analyzer was utilized to measure urine white blood cell (WBC) and bacteria (BACT), with the findings being compared to the culture results.
At ≥ 104 colony-forming unit (CFU)/mL, 513 samples were culture-positive (400 samples presented 104-105 CFU/mL, and 113 demonstrated ≥ 105 CFU/mL bacterial growth). Optimal indicators for positive cultures were BACT counts of 92.2/μL (AUC: 0.944) and WBC counts of 40.8/μL (AUC:0.863). False negative rate were 0.9% when using a 7.8 bacteria/μL cut-off and avoiding unnecessary cultures in 28.1%. The UF-5000 has a higher consistency rate for Gram-negative (GN) bacteria (90.3%) than Gram-positive (GP) bacteria (86.8%). For samples with 105 CFU/mL, UF-5000's Bacteria -Information flags showed superior concordance for samples with 104-105 CFU/mL bacteria.
Screening pediatric urine cultures with the UF-5000 showed potential application value in identifying negative cultures and significant bacterial growth, although performance may vary depending on the study population. Furthermore, detecting Gram typing aids in guiding early clinical empirical medication, particularly for UTIs caused by GN bacteria.
需要一种快速的儿童尿路感染（UTI）筛查试验，以避免不必要的培养并提供及时报告，以便做出适当的临床决策。我们首次评估了 Sysmex UF-5000 流式细胞仪作为儿童 UTI 筛查工具的性能。
本研究纳入了 4445 例儿科患者，收集了 2020 年 1 月至 2023 年 9 月的尿沉渣和尿液培养数据。使用 Sysmex UF-5000 分析仪测量尿液白细胞（WBC）和细菌（BACT），并将结果与培养结果进行比较。
在≥104 个菌落形成单位（CFU）/mL 时，513 个样本培养阳性（400 个样本 104-105 CFU/mL，113 个样本≥105 CFU/mL 细菌生长）。阳性培养的最佳指标为 BACT 计数 92.2/μL（AUC：0.944）和 WBC 计数 40.8/μL（AUC：0.863）。当使用 7.8 个细菌/μL 的截断值且避免不必要的培养时，假阴性率为 0.9%，可避免 28.1%的不必要培养。UF-5000 对革兰氏阴性（GN）细菌的一致性率（90.3%）高于革兰氏阳性（GP）细菌（86.8%）。对于 105 CFU/mL 的样本，UF-5000 的细菌-信息标志对于 104-105 CFU/mL 细菌的样本具有更高的一致性。
使用 UF-5000 筛查儿科尿液培养物具有识别阴性培养物和显著细菌生长的潜在应用价值，尽管性能可能因研究人群而异。此外，检测革兰氏分型有助于指导早期临床经验性用药，特别是对于 GN 细菌引起的 UTI。
