Lohr J A, Portilla M G, Geuder T G, Dunn M L, Dudley S M
Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill 27599.
J Pediatr. 1993 Jan;122(1):22-5. doi: 10.1016/s0022-3476(05)83481-x.
The purpose of our study was to characterize the utility of certain elements of urinalysis, singly or in combination, in identifying children with urinary tract infections (i.e., positive findings on urine culture). Laboratory results for urine specimens subjected to both urinalysis and culture in an on-site outpatient clinic (office) laboratory during a 36-month period were reviewed. All specimens were collected by one of three methods (the midstream void technique, urethral catheterization, or suprapubic aspiration of urine) from children with symptoms to assist in documenting a possible urinary tract infection. Specimen processing by certified technologists was initiated within 10 minutes of collection. Sensitivity, specificity, and positive and negative predictive values were determined for each test or combination of tests. Of 689 specimens, 102 (14.8%) had positive culture results. The combination of dipstick analysis (leukocyte esterase and nitrite tests) and of microscopic examination for bacteria had a sensitivity of 100% and a negative predictive value of 100%. The nitrite test had a specificity of 100% and a positive predictive value of 100%. We conclude that, when properly collected specimens are evaluated promptly by certified technologists, the rate of accuracy in detecting or ruling out a urinary tract infection (i.e., positive findings on urine culture) with certain elements of the urinalysis is high.
我们研究的目的是确定尿液分析中某些单独或联合的元素在识别患有尿路感染（即尿培养结果呈阳性）儿童方面的效用。回顾了在一个现场门诊（办公室）实验室36个月期间接受尿液分析和培养的尿液标本的实验室结果。所有标本均通过三种方法之一（中段尿采集技术、尿道插管或耻骨上膀胱穿刺取尿）从有症状的儿童中采集，以协助记录可能的尿路感染。标本由认证技术人员在采集后10分钟内开始处理。确定了每项测试或测试组合的敏感性、特异性、阳性预测值和阴性预测值。在689份标本中，102份（14.8%）培养结果呈阳性。试纸条分析（白细胞酯酶和亚硝酸盐测试）与细菌显微镜检查相结合的敏感性为100%，阴性预测值为100%。亚硝酸盐测试的特异性为100%，阳性预测值为100%。我们得出结论，当认证技术人员及时对正确采集的标本进行评估时，利用尿液分析中的某些元素检测或排除尿路感染（即尿培养结果呈阳性）的准确率很高。
