Automated flow cytometric analysis of cerebrospinal fluid

BACKGROUND: Recently, the UF-100 (Sysmex Corporation) flow cytometer was developed to automate urinalysis. We evaluated the use of flow cytometry in the analysis of cerebrospinal fluid (CSF). METHODS: UF-100 data were correlated with microscopy and biochemical data for 256 CSF samples. Microbiological analysis was performed in 144 suspected cases of meningitis. RESULTS: Good agreement was obtained between UF-100 and microscopy data for erythrocytes (r = 0.919) and leukocytes (r = 0.886). In some cases, however, incorrect classification of lymphocytes by the UF-100 led to underestimation of the leukocyte count. UF-100 bacterial count positively correlated (P < 0.001) with UF-100 leukocyte count (r = 0.666), CSF total protein (r = 0.754), and CSF lactate concentrations (r = 0.641), and negatively correlated with CSF glucose concentration (r = -0.405; P < 0.001). UF-100 bacterial counts were unreliable in hemorrhagic samples and in samples collected by ventricular drainage where interference by blood platelets and cell debris was observed. Another major problem was the UF-100 "bacterial" background signal in sterile CSF samples. Cryptococcus neoformans yeast cells and cholesterol crystals in craniopharyngioma were detected by the flow cytometer. CONCLUSIONS: Flow cytometry of CSF with the UF-100 offers a rapid and reliable leukocytes and erythrocyte count. Additional settings offered by the instrument may be useful in the diagnosis of neurological disorders.     

UF-1000i 在脑脊液细胞分析及红细胞来源鉴别中的应用

目的 评价UF-1000i 在脑脊液细胞分析中的应用.方法 用UF-1000i 和显微镜分别检测216份脑脊液标本中的红细胞、白细胞和上皮细胞,并对结果进行统计学分析.结果 UF-1000i 检测红细胞、白细胞、上皮细胞与显微镜法计数法具有高度的相关性;UF-1000i 的红细胞平均前向散射光强度直方图可以辅助鉴别蛛网膜下腔出血和穿刺出血.结论 UF-1000i 计数脑脊液中的细胞具有结果准确、快速、重复性好等特点,适合辅助脑脊液标本中细胞成分的临床常规分析,同时,对血性脑脊液的鉴别也有较好的辅助作用.     

Sysmex UF-1000i全自动尿沉渣分析仪的性能分析及临床应用

目的探讨Sysmex UF-1000i全自动尿沉渣分析仪的临床应用情况。方法分别采用UF-1000i尿沉渣分析仪和显微镜检查法对2 000例临床标本进行检测,对比2种方法的结果,并分析UF-1000i尿沉渣分析仪产生假阳性的原因。结果检测白细胞(WBC),红细胞(RBC),管型和小圆上皮细胞的敏感性分别为99.2%,99.3%,94.7%和95.1%;检测上述成分的假阳性率分别为5.8%、6.1%、10.4%和4.6%;粘液丝、结晶、细菌、酵母菌、小圆上皮、脂肪滴和卵磷脂小体可能影响到UF-1000i对尿有形成分的检测。结论 Sysmex UF-1000i可以有效的检测尿液中的有形成分,当尿液中上述干扰成分呈阳性或增多时,显微镜镜检是十分重要的。     

尿流式有形成分及干化学分析在尿路感染诊断中的应用评价

目的 评价尿干化学分析及UF-1000i流式尿有形成分分析单独及联合应用时在尿路感染诊断中的应用价值.方法 留取148例尿路感染(UTI)患者、284例非尿路感染患者的中段尿标本,分别用培养法做尿细菌计数和鉴定,用UF-1000i流式尿有形成分分析仪做细菌计数(BACT)、酵母样菌(YEC)、WBC检测,用URISYS 2400尿干化学分析仪做自细胞酯酶(LEU)、亚硝酸盐(NIT)检测.评价尿干化学分析、UF-1000i流式尿有形成分分析仪以及UF-1000i联合尿干化学分析与定量尿细菌培养对诊断UTI的一致程度,并评价其对UTI诊断的敏感度、特异度、阳性预测值、阴性预测值、准确度.结果 在148例尿路感染患者中,定量尿细菌培养的检出率为73.6%(109/148),尿干化学分析LEU和NIT同时为阳性的检出率为26.4%(39/148),两种方法的检出率之间差异有统计学意义(χ2=55.68,P<0.05).UF-1000i流式尿有形成分分析BACT和WBC任意1项为阳性诊断UTI的检出率为91.2%(135/148),高于定量尿细菌培养的检出率,差异有统计学意义(χ2=14.70,P<0.05).UF-1000i流式尿有形成分分析和尿干化学分析仪联合参数BACT、WBC、LEU和NIT任意1项为阳性诊断UTI的检出率为94.6%(140/148),高于定量尿细菌培养的检出率,差异有统计学意义(χ2=20.45,P<0.05).尿干化学分析敏感度较低,为26.4%(39/148),特异度较高,为99.3%(282/284);应用UF-1000i流式尿有形成分分析BACT作为尿路感染诊断依据时的敏感度为92.6%(137/148),特异度为39.8%(113/284),阳性预测值为44.5%(137/308),阴性预测值为91.1%(113/124);尿干化学分析与UF-1000i流式尿有形成分分析联合应用时,敏感度为98.O%(145/148),阴性预测值97.1%(100/103),特异度为35.2%(100/284),阳性预测值为44.1%(145/329),准确度为56.7%(245/432).结论 联合UF-1000i流式尿有形成分分析及尿干化学分析可在早期尿路感染筛查诊断中发挥重要作用;同时对尿细菌培养为阴性的UTI患者的明确诊断具有重要价值.     

2种尿沉渣分析仪检测红、白细胞的比较与评价

目的评价Cobio XS和Sysmex UF-1000i2种尿沉渣分析仪检测红白细胞的可靠性。方法选取红细胞和白细胞在高、中、低3个不同浓度水平的尿液标本在Cobio XS和Sysmex UF-1000i尿沉渣分析仪检测,测定2台仪器的重复性。将新鲜血标本稀释戍不同的浓度,测定2台仪器的稀释线性。收集住院患者尿液标本176份,以FAST-READ102沉渣计数板结果为标准,统计2种仪器的假阳性率,假阴性率。结果Cobio XS尿沉渣分析仪经人工校正后高、中、低值3水平的白细胞重复性变异系数为5．53％、6．29％、4．21％,红细胞变异系数为3．47％、4．98％、3．32％。Sysmex UF－1000i尿沉渣分析仪白细胞的重复性变异系数为2．74％、2．31％、2．90％,红细胞变异系数为1．75％、1．26％、1．39％。Sysmex UF－1000i尿沉渣分析仪红细胞在7～10210个／μL线性范围内的相关系数为0．9999,Cobio XS尿沉渣分析仪红细胞在4～5300个／μL线性范围内的相关系数为0．9993。Sysmex UF-1000i尿沉渣分析仪红细胞白细胞的假阳性率分别为43．8％和20．5％,Cobio XS尿沉渣分析仪分别为3．4％和11．4％。Sysmex UF-1000i尿沉渣分析仪红细胞白细胞的假阴性率分别为0．6％和0．6％,Cobio XS尿沉渣分析仪分别为1．7％和1．7％。结论Cobio XS和Sysmex UF-1000i尿沉渣分析仪均有良好的稀释线性。Sysmex UF-1000i尿沉渣分析仪的重复性较Cobio XS尿沉渣分析仪好,Sysmex UF-1000i尿沉渣分析仪红细胞白细胞的假阳性率明显高于Cobio XS尿沉渣分析仪,假阴性率稍低于Cohio XS尿沉渣分析仪。     

Sysmex UF-1000i全自动尿沉渣分析仪的性能分析及临床应用

目的探讨Sysmex UF-1000i全自动尿沉渣分析仪的临床应用情况。方法分别采用UF-1000i尿沉渣分析仪和显微镜检查法对2 000例临床标本进行检测,对比2种方法的结果,并分析UF-1000i尿沉渣分析仪产生假阳性的原因。结果检测白细胞（WBC）,红细胞（RBC）,管型和小圆上皮细胞的敏感性分别为99.2%,99.3%,94.7%和95.1%;检测上述成分的假阳性率分别为5.8%、6.1%、10.4%和4.6%;粘液丝、结晶、细菌、酵母菌、小圆上皮、脂肪滴和卵磷脂小体可能影响到UF-1000i对尿有形成分的检测。结论 Sysmex UF-1000i可以有效的检测尿液中的有形成分,当尿液中上述干扰成分呈阳性或增多时,显微镜镜检是十分重要的。     

菌尿对两种全自动尿沉渣分析仪检测尿红细胞的影响

目的探讨不同菌种、不同浓度细菌对Sysmex UF-1000i和IRISIQ-200全自动尿沉渣分析仪检测尿红细胞的影响,比较两种全自动尿沉渣分析仪检测尿红细胞时的抗细菌干扰能力。方法不同浓度的红细胞尿液加入不同菌种、不同浓度的细菌后分别用Sysmex UF-1000i和IRISIQ-200进行检测,比较加入细菌前后检测结果的差异。结果铜绿假单胞菌、金黄色葡萄球菌和大肠埃希菌对Sysmex UF-1000i和IRISIQ-200检测尿中红细胞没有显著影响,白色念珠菌和热带念珠菌可干扰Sysmex UF-1000i和IRISIQ-200对尿中红细胞的检测,但两种仪器受干扰程度有差异。结论 Sysmex UF-1000i和IRISIQ-200对尿红细胞检测在一定程度上可受到真菌的影响,结果报告应结合干化学检测和手工显微镜检查。     

The efficient workflow to decrease the manual microscopic examination of urine sediment using on-screen review of images

BackgroundThe manual microscopic examination (MME) of urine sediment is labor-intensive, time-consuming, and imprecise. Therefore, automated urinalysis systems based on flow cytometry or digital imaging techniques could replace MME. The purpose of this study was to evaluate the rate of MME using two automated urine sediment analyzers, alone and in combination.MethodsThis study was conducted using the freshly collected urine specimens of 1055 in-patients and 1119 out-patients. All samples were analyzed using UF-1000i (Sysmex Corporation) and Cobas 6500 instrument (Roche Diagnostics International). The rate of MME was evaluated using two analyzers, both individually and in combination.ResultsUsing the UF-1000i alone, 34.2% and 16.8%, respectively, of in- and out-patient samples were analyzed by MME, compared to 15.6% and 3.7%, respectively, using the Cobas 6500. In combined assay using the UF-1000i followed by the Cobas 6500, 27.9% and 11.3% in-patient samples required on-screen review and MME, respectively. And the respective rates were 10.3% and 2.7% of out-patient. Samples using the Cobas 6500 followed by the UF-1000i, 42.3% and 11.3% in-patient needed on-screen review and MME, respectively. And the respective rates were 18.9% and 2.7% of out-patient samples.ConclusionsUse of the Cobas 6500 compared to the UF-1000i resulted in decreases in the rate of MME from 34.2% to 15.6% for in-patient samples, and from 16.8% to 3.7% for out-patient samples. Use of the Cobas 6500 reduced the rate of MME, and compared to use of only the Cobas 6500, the combined use resulted in a reduction in the rate of on-screen review.     

IQ-200与UF-100全自动尿沉渣分析仪管型检测对比分析

目的对比分析IQ-200全自动尿沉渣分析仪与UF-100全自动尿沉渣分析仪管型检测的灵敏度、特异性以及影响因素。方法选择320例干化学法尿蛋白(+)及以上的住院患者晨尿标本,分别用IQ-200全自动尿沉渣分析仪、UF-100全自动尿沉渣分析仪及显微镜检查。结果 IQ-200和UF-100全自动尿沉渣分析仪对管型检测的检出率不一致,IQ-200全自动尿沉渣分析仪对管型检出的灵敏度为44.2%,特异度为88.4%;UF-100全自动尿沉渣分析仪对管型检出的灵敏度为88.5%,特异度为33.2%。结论 IQ-200全自动尿沉渣分析仪和UF-100全自动尿沉渣分析仪管型检测相比,特异度更高,灵敏度更低,2台仪器对管型的检测都还不能完全代替显微镜镜检。     

Urine particles analysis: Performance evaluation of Sysmex UF-1000i and comparison among urine flow cytometer,dipstick, and visual microscopic examination

Abstract

Introduction. Our objective was to evaluate a newly invented urine flow cytometer, and select an optimal strategy for urinalysis in clinical practice. Methods. The performance of UF-1000i was evaluated in both control material and patient samples. A total of 1631 specimens were collected and analysed by visual microscopy examination (VME), UF-1000i flow cytometer (Sysmex Medical Electronics Co, Kobe, Japan) and an automated dipstick reflectometer Clinitek Atlas (Bayer Corp, Elkhart, USA). Results. UF-1000i showed good imprecision performance for the main parameters in urine particles with CV values less than 20%. The results from UF-1000i correlated well with VME for erythrocytes (r = 0.96), leukocytes (r = 0.98), and epithelial cell (r = 0.84). The area under the receiver operating curve (AUC) was 0.879, 0.903, 0.783, and 0.817 respectively for erythrocytes, leukocytes, bacteria and CAST in UF-1000i. While in Clinitek Atlas, the AUC was 0.848, 0.803, 0.761, and 0.754 respectively. Sensitivity of combination of the two methods for screening remained at 98% as compared to VME alone, while reducing the visual review rate down to 40%. Conclusion. UF-1000i is capable of reproducible measurement of urine particles in the clinically relevant range and shows its advantage over Atlas. Combination of the two methods is an optimal strategy for urine sample screening.     

罗氏U701和希森美康UF-1000i两种尿沉渣分析仪不同分析原理检测细菌结果差异性比较

目的 以中段尿细菌培养为标准,比较荧光染色法和图像智能判读法两种原理的尿沉渣分析仪细菌结果的差异性。方法 对选取上海市第六人民医院金山分院2018年11月疑似尿路感染患者的223份中段尿样品进行细菌培养和鉴定,接种之后,该样品分别在罗氏U701和希森美康UF-1000i上进行检测,最后对尿标本进行离心涂片染色镜检。以培养结果为金标准,分析两台设备的敏感度、特异度和正确度,从而比较两台设备检测细菌的性能。结果 223份尿样品培养出革兰阳性菌20株,革兰阴性菌35株。UF-1000i,离心涂片染色镜检和U701的结果分别与细菌培养结果比较,UF-1000i和离心涂片染色镜检的正确度分别为98.2%和99.1%,且差异无统计学意义(均P>0.05)。U701的三种参考范围的结果中,“-”组、“-～1+”和“-～2+”的正确度分别为67.3%,91.5%和87.4%,与细菌培养结果比较差异均有统计学意义(均P<0.05)。结论 UF-1000i的细菌结果对于尿路感染的提示优于U701,U701细菌结果的参考范围建议为“-～1+”。     

Sysmex UF-1000i尿流式分析仪检测住院患者尿标本类酵母菌的临床评价

目的评价Sysmex UF-1000i尿流式分析仪检测尿标本类酵母菌的分析性能。方法应用尿流式分析仪检测我院住院患者尿标本,对仪器检测类酵母菌阳性尿标本进行镜检、培养鉴定;同时随机选择同期仪器检测阴性标本作对照。结合临床,判断患者尿路类酵母菌定植或感染。结果 2010年10月-2010年12月间共检测6019份尿标本,尿流式分析仪检测类酵母菌阳性127份,经培养证实82份为真阳性。同期仪器检测阴性标本121份中有12份培养阳性。以培养作为金标准,尿流式分析仪分析尿中类酵母菌试验敏感性为87.23%、特异性为70.78%、准确度为77.02%、阳性预测值为64.57%,阴性预测值为90.08%。菌种前三位的是以光滑念珠菌(43.40%)、白念珠菌(21.69%)、热带念珠菌(14.15%)。阿萨希毛孢子菌也存在一定比例(5.66%)。尿中类酵母菌真阳性患者多数患有多种基础疾病,以2型糖尿病(25.61%)、慢性泌尿系统疾病(18.29%)和颅脑脊髓损伤(17.07%)为主;实施的医疗措施以抗细菌药物(52.44%)、留置导尿管(35.37%)多见(P<0.05)。尿流式分析仪检测阴性而培养阳性12例患者均为尿路念珠菌定植。尿流式分析仪检测阳性并且培养阳性82例患者中,69例(84.15%)为类酵母菌尿路定植;13例(15.85%)为尿路感染,其中1(1.22%)例发展为热带念珠菌血症。结论 Sysmex UF-1000i尿流式分析仪对尿标本类酵母菌有较强的筛查价值。实验室应对仪器类酵母菌检测阳性标本进行镜检后确认。临床医师应对类酵母菌检测阳性患者结合其临床表现,采取不同的治疗措施。     

UF-100尿沉渣分析仪在临床应用中价值探讨

目的探讨UF-100全自动尿沉渣细胞分析仪在实际工作中的应用价值。方法随机选取1202份尿液标本同时进行UF-100尿沉渣分析、尿干化学分析和显微镜检测,分析多个参数指标。结果大多数标本三种检测方法结果较一致,在尿液有形成分的检测方面,UF-100对RBC、WBC、EC、CAST有较高的检出率,并能检测到溶解的红细胞(影红细胞),而对管型、真菌的假阳性太多,必须以显微镜镜检为准。结论UF-100在一定范围内能对尿标本中的有形成分进行准确计数,定量报告,并能提示红细胞相关信息,与尿试纸法联合应用,将大大降低显微镜复检的工作量,提高工作效率。     

Prediction of presence of fastidious bacteria by the Fully Automated Urine Particle Analyzer UF-1000i in the case of ineffective antimicrobial therapy for urinary tract infection

IntroductionRecent studies have reported associations between fastidious bacteria that are difficult to grow and isolate in conventional urine culture conditions and urinary tract infections (UTIs). Because the Fully Automated Urine Particle Analyzer UF-1000i (hereinafter referred to as “UF-1000i”) detects fastidious bacteria without being affected by culture conditions, owing to its flow cytometry-based principle, we evaluated the robustness of UF-1000i detection using clinical urine samples from patients with UTIs following ineffective antimicrobial therapy.MethodsA total of 150 patients diagnosed with UTIs were enrolled, and their laboratory findings were analyzed, focusing on the discrepancy in bacterial numbers between UF-1000i and conventional culture at each antimicrobial therapy effectiveness classification. In addition, gene identification was conducted by molecular analysis using 16S ribosomal RNA gene sequencing and next-generation sequencing (NGS) to elucidate the reason for the presence of fastidious bacteria in these samples.ResultsThe ineffective therapy cases showed more than 100-fold discrepancy in bacterial counts, with a higher proportion (30.8%) than effective therapy cases without secondary administration (5.7%) between the bacterial counts in UF-1000i and conventional culture methods. The presence rates of fastidious bacteria were 100% and 66.7% in discrepant cases of ineffective and effective without secondary administrations, respectively.ConclusionThis study suggests that discrepancies in bacterial numbers between the conventional culture method and UF-1000i measurement at the primary visit can predict the presence of fastidious bacteria, especially in cases of ineffective antimicrobial therapy.     

Evaluation of the XE-5000 for the automated analysis of blood cells in cerebrospinal fluid

ObjectivesCounting of cells in cerebrospinal fluid is an important clinical laboratory test and elevated white blood cell counts in cerebrospinal fluid are frequently seen in CNS disorders. Quantification of red blood cell concentrations in CSF may help to interpret certain diagnostic constellations and may result from subarachnoid haemorrhage, surgical procedures or contamination due to traumatic puncture. Table top analyser XE-5000 (Sysmex, Norderstedt, Germany) offers, beside its use as a haematology analyser, a protocol for the quantification of red and white blood cells in body fluids such as CSF including the differentiation between polymorphonuclear and mononuclear cells. A detection limit of 1 cell/mm³ would render this device suitable for automated CSF analysis.Design and methodsWhite blood cell counting was compared between Fuchs–Rosenthal counting chamber and XE-5000 in 273 routinely collected lumbar and ventricular CSF samples. Red blood cell counting was compared between UF-100 and XE-5000. Differentiation was performed on a slide stained after Pappenheim and compared to the differential count of the XE-5000.ResultsLinearity was established between 1 and 10,000 cells/mm³ for white blood cells and between 1000 and 1 ? 10³ particles/mm³ for red blood cells. Functional sensitivity was established at 20 cells/mm³ for white blood cell counting and at 1000 particles/mm³ (lowest reported concentration) for red blood cell counting. When comparing between microscopic and automatic white blood cell counts no statistically significant slope and offset were detected in lumbar CSF samples while a significant slope and offset were detected when comparing ventricular CSF samples. Most patients were classified correctly according to their WBC count (non-pathologic, mildly, moderately, and highly elevated) by both methods although more patients had pathologic white blood cell counts on XE-5000. A significant slope and offset were detected when comparing red blood cell counts between UF-100 and XE-5000.ConclusionsIn summary despite its high imprecision at low white blood cell counts (< 20 particles/mm³) most patients were classified correctly and therefore XE-5000 is suitable for automated quantification of white blood cells in cerebrospinal fluid in a defined diagnostic setting. This could significantly improve automation in the relatively time- and manual work-intensive field of cerebrospinal fluid diagnostics. However, careful review of plausibility of the results continues to be compulsory.     

Roche Cobas 6500全自动尿液分析仪与其他系统的性能比较及效率评估

目的观察罗氏Roche Cobas 6500全自动尿液分析流水线与Arkray AX-4030、Urisys 2400、Sysmex UF-1000i尿液干化学、尿液有形成分检测结果之间的可比性。方法分别对Cobas u601与Urisys 2400尿液干化学检测性能,Cobas u601与Arkray AX-4030、Urisys 2400抗维生素C的干扰能力评估;比较Cobas u701与KOVA人工镜检计数在尿液有形成分检测差异,比较Cobas u701和Sysmex UF-1000i检测透明管型(Hya)、尿细菌计数(Bac)、病理管型(Pat)及结晶(Cry)的结果差异;比较Cobas 6500系统与Arkray AX-4030、Sysmex UF-1000i联合检测时的周转时间(TAT)差异。结果 Cobas u601与Urisys 2400尿液干化学9个参数检测结果的比对符合率均超过90%;Cobas 6500携带污染率为0%,未发现携带污染且未受到维生素C的干扰。在尿液有形成分检测中,Cobas 6500与镜检标准对照,阴阳性符合率均较高。结论 Cobas u601、Cobas u701与其他仪器检测结果的符合率较高,在检测重复性、携带污染率、抗维生素C干扰方面较好,Cobas 6500尿液分析仪能提高检验科日常TAT。     

Time-course of quantitative urinary leukocytes and bacteria counts during antibiotic therapy in women with symptoms of urinary tract infection

BACKGROUND: Urinary tract infections are generally diagnosed by test strips and microscopic semi-quantitative sediment analyses. However, results are uncertain because of lacking standardisation and limited sensitivity in low-count-bacteriuria. Flow cytometry UF-100 was used to analyse particles quantitatively in urine in women with urinary tract infections during the period of antibiotic therapy. The aim was to follow the courses of leukocytes and bacteria during infections and to gain information about the reasons for successful or unsuccessful outcomes. METHOD: Quantitative leukocytes and bacterial counts in urine of 16 symptomatic women were performed at presentation and each day during the antibiotic treatment by flow cytometry UF-100. RESULTS: Leukocytes in urine were between 30 and 15,000 (x10(6)/L) at presentation (cut-off 20x10(6)/L). Bacteria counts from flow cytometry were mainly 5x10(9)/L-100x10(9)/L (cut-off of 3x10(9)/L). The deepest decreases in cell counts were noted during the first 24 h after initiation of therapy and gained normal values at the end of treatment in successful outcomes. A slower or no decrease was noted in unsuccessful treatments. CONCLUSION: The precise leukocyte and bacteria counting by flow cytometry and their follow-up during urinary tract infections gave early information about outcomes of therapy.     

Limits of preservation of samples for urine strip tests and particle counting

BACKGROUND: Preservation of urine samples is important for centralised laboratory services with automated instruments. METHODS: A multicentre evaluation was carried out to assess preservative tubes from BD Diagnostics-Preanalytical Systems and from Greiner Bio-One for test strip reading (documented at the level of remission values), for particle counting by flow cytometers (UF-100) and for visual microscopy. Failures were expressed as percentages of originally positive samples beyond a two-fold change (+100% or -50%) from the original values. RESULTS: The preservative-containing BD Plus C&S plastic, BD Plus UAP and Greiner Stabilur tubes succeeded in preservation of test strip results for 6-24 h (exceptions were glucose and nitrite tests). Greiner boric acid tube showed false negative results in leukocyte, protein and ketone strip tests immediately after adding the preservative. Urine red blood cell counts (with Sysmex UF-100) were preserved for 5 h in BD Plus C&S plastic and Greiner Stabilur tubes (Greiner tubes having clearly larger preservative-related background). Bacteria or white blood cell counting succeeded in BD Plus C&S plastic tubes for 5 or 24 h, respectively, but up to 72 h in Greiner Stabilur tubes. In visual microscopy, the Greiner Stabilur tube was slightly better than the BD Plus C&S plastic tube. CONCLUSIONS: Urine specimens can be transported at +20 degrees C on the day of collection if preserved properly. Longer delays need careful planning with current preservatives. Flow cytometry with UF-100 is sensitive to non-dissolved preservative remnants.     

Pediatric reference values for urine particle quantification by using automated flow cytometer: Results of a multicenter study of Italian urinalysis group

Objectives

The purpose of this Italian multicenter study was to define pediatric upper reference values for urine particle quantification by using automated flow cytometry.

Design and methods

Four hospital-based clinical laboratories participated in this multicenter investigation, which included a total study population of 161 Italian children aged from 1 to 12 years. Two laboratories used Sysmex UF-100 and analyzed 86 children, whereas the other two used Sysmex UF-1000i and analyzed 75 subjects. Particle quantification included the analysis of white blood cells (WBC), red blood cells (RBC), squamous epithelial cells (EC), transitional epithelial cells (TC), casts (CAST) and bacteria (BACT).

Results

The upper reference values in subjects tested with the Sysmex UF-100 were 9.7 WBC/μL, 10.1 RBC/μL, 7.5 EC/μL, 2.5 TC/μL, 0.7 CAST/μL and 3090 BACT/μL, whereas the upper reference values in subjects tested with the Sysmex UF-1000i were 10.5 WBC/μL, 8.3 RBC/μL, 7.2 EC/μL, 2.9 TC/μL, 0.7 CAST/μL and 48 BACT/μL. No statistically significant differences between genders were found in the value distribution of any of the parameters tested. Similarly, no statistically significant differences were observed between the two urine analyzers, except for BACT.

Conclusions

Automated analysis of urine particles appears a suitable means to optimize the workflow of routine urinalysis of children specimens. The upper reference limits for pediatric subjects obtained in this study were comparable to those previously reported in the literature, with no significant differences between genders and analyzers.     

Sysmex UF-500i全自动尿沉渣分析仪计数L型大肠埃希菌研究

目的：分析Sysmex UF-500i全自动尿沉渣分析仪对大肠埃希菌L型细菌计数的特点。方法氨苄西林诱导大肠埃希菌成L型,观察细菌L型的菌落、形态、染色特点;配制一定菌液浓度,并用培养法验证配制菌液的实际浓度;用 Sysmex UF-500i 全自动尿沉渣分析仪对已知菌液浓度菌液进行细菌计数;比较大肠埃希菌L型理论浓度与Sysmex UF-500i全自动尿沉渣分析仪细菌计数结果的差异。结果氨苄西林极易诱导大肠埃希菌成为L 型,细菌L 型形态、染色与细菌型有极大不同;Sysmex UF-500i全自动尿液沉渣分析仪测定大肠埃希菌L型细菌计数结果远低于理论浓度。结论大肠埃希菌不稳定L型与相对稳定L型在Sysmex UF-500i全自动尿沉渣分析仪细菌计数结果,与细菌型计数不同;由于细菌的聚集性,所测定的细菌个数远低于实际细菌数;为了准确得出尿沉渣细菌计数结果,最好在临床用药前送检尿液标本。