Mcguckin M, Cohen L, Macgregor R R
J Urol. 1978 Oct;120(4):452-4. doi: 10.1016/s0022-5347(17)57227-4.
Microscopic examination of the urinary sediment to determine the degree of pyuria is an accepted method to screen for urinary tract infection. We investigated the significance of pyuria in relation to the method of specimen acquistion, number of white blood cells and isolation of pathogens on culture. Only 36 per cent of our patients with more than 10 white blood cells per high power field on examination of the first random specimen had more than 10 white blood cells per high power field when a repeat clean catch midstream specimen was examined, and only 20 per cent of the patients had more than 10(5) pathogens per ml. on culture. However, the finding of more than 10 white blood cells per high power field on a clean catch mid stream specimen indicated more than 10(5) pathogens per ml. in 40 per cent of the cases. The use of a higher threshold for significant pyuria (more than 20 white blood cells per high power field) on examination of a random specimen increased the incidence of more than 10(5) bacteriuria found in specimens with initial pyuria by 43 per cent and represents the additional detection of 8.7 per cent of the total poputation studied. These data indicate that when screening for pyuria and infection one should either obtain a clean catch midstream specimen for examination of urinary sediment or increase the threshold for significant pyuria on a random specimen.
通过显微镜检查尿沉渣以确定脓尿程度是筛查尿路感染的一种公认方法。我们研究了脓尿与标本采集方法、白细胞数量以及培养中病原体分离之间的关系。在我们的患者中，首次随机标本检查时每高倍视野白细胞超过10个的患者，再次检查清洁中段尿标本时，只有36%的患者每高倍视野白细胞仍超过10个，并且只有20%的患者培养时每毫升病原体超过10⁵个。然而，清洁中段尿标本每高倍视野白细胞超过10个的结果表明，40%的病例每毫升病原体超过10⁵个。在随机标本检查时，将显著脓尿的阈值提高（每高倍视野超过20个白细胞），使初始有脓尿的标本中每毫升细菌尿超过10⁵个的发生率增加了43%，这意味着在所研究的总人群中额外检测出8.7%。这些数据表明，在筛查脓尿和感染时，要么获取清洁中段尿标本进行尿沉渣检查，要么提高随机标本中显著脓尿的阈值。
