UF-1000i尿有形成分分析仪在尿路感染筛查中的应用评价

目的评价UF-1000i尿流式有形成分分析仪在尿路感染（UTI）筛查中的应用价值。方法应用UF—1000i尿流式有形成分分析仪检测148例疑似uTI患者中段尿标本中的细菌（BACT）数和白细胞（WBC）数,以定量尿细菌培养作为诊断UTI金标准,应用受试者工作特征（ROC）曲线确立阳性判断标准,评价UF-1000i尿流式有形成分分析仪诊断UTI的敏感性、特异性、阳性预测值、阴性预测值和准确性。结果UF—1000i尿有形成分分析仪BACT和WBC诊断UTI的cut—off值分别为325个／汕和48个／μL,其诊断UTI的敏感性、特异性、阳性预测值、阴性预测值、准确性分别是：78．3％、92．2％、81．8％、90．4％、87．8％和73．9％、81．4％、64．2％、87．4％、79．1％。UF—1000i联合诊断uTI的敏感性、特异性、阳性预测值、阴性预测值和准确性分别95．7％、70．6％、59．5％、97．3％、78．4％。结论UF．1000i尿有形成分分析仪可作为UTI的快速筛查工具。     

Sysmex UF-1000i全自动尿液分析仪在细菌性尿路感染中的应用

目的探讨Sysmex UF-1000i全自动尿液分析仪(简称UF-1000i)用于筛检细菌性尿路感染的可行性。方法 134例中段尿标本在作病原菌分离培养后立即用UF-1000i检测细菌(BACT)、酵母菌(YLC)2项参数。以培养结果作为金标准,以评价这两项参数的灵敏度、特异度、假阳性率、假阴性率。结果 UF-1000i的BACT和YLC的最佳临床判断值为3 876.9/μL、38.6/μL,灵敏度为82.3%、72.9%,特异度为79.3%、88.9%,假阳性率16.4%、1.8%,假阴性率为2.8%。结论 UF-1000i用于筛检细菌性尿路感染和真菌感染具有一定的价值,但不能完全代替病原体的培养鉴定。     

UF-1000i自动尿液分析仪对尿路感染的诊断价值

目的 了解UF-1000i分析仪对尿路感染的诊断价值.方法 以细菌培养为金标准,通过ROC曲线分析,把UF-1000i分析仪的细菌计数和WBC计数结果 与之比对,来计算其敏感度、特异度、假阳性率、假阴性率、真阳性率、真阴性率,用以评价其对尿路感染的诊断价值.结果 以尿细菌培养为金标准,UF-1000i分析仪的WBC计数...     

UF-1000i尿液分析仪细菌计数在筛查儿童尿路感染中的应用

尿路感染是婴幼儿时期常见疾病,病原体主要是细菌,也可为真菌。尿路感染实验室诊断的金标准是中段尿细菌培养,但耗时长,成本高。UF-1000i尿液有形成分分析仪有单独的细菌通道,对细菌进行特殊染色并计数。本研究探讨尿液细菌计数在儿童尿路感染筛查中的应用。     

UF-1000i全自动尿液分析仪诊断及鉴别不同细菌引起的尿路感染中的应用

目的 建立一种新的既快速又准确的诊断尿路感染的初筛方法,评价UF-1000i在尿路感染中的诊断价值.方法 利用UF-1000i对607份尿液标本进行定量分析,包括红细胞、白细胞、细菌等有形成分,同时与尿培养结果进行比较.结果 在诊断尿路感染的患者中,UF-1000i测定的白细胞与细菌数的临界值分别为55.3/μl和595.2/μl,特异度97.4%,敏感度86.5%,阴性预测值98.5%.结论 利用UF-1000i测定尿液标本能够提高尿路感染的诊断效率.在较短时间内报告出的阴性结果将避免了不必要的细菌培养,B-FSC(细菌前散射光)和B-FLH(细菌荧光强度)这两个参数在革兰氏阳性菌和革兰氏阴性菌的区分上提供了有价值的信息.分析结果显示,当B-FSC小于38ch时,95%的标本细菌培养都是革兰氏阴性菌.     

全自动尿液有形成分分析仪细菌检测对尿路感染诊断的效果研究

目的研究UF-4000型全自动尿液有形成分分析仪中细菌检测指标对于尿路感染(UTI)患者的作用与效果。方法纳入我院收治的258例疑似为UTI病例的尿液样本,纳入时间为2018年11月-2019年6月,借助UF-4000型全自动尿液有形成分分析仪、尿液细菌培养与鉴定,观察比较其结果。结果UF-4000型全自动尿液有形成分分析仪中细菌检测指标的总阳性率33.72%(87/258),细菌培养的总阳性率29.46%(76/258),进行对比没有十分显著的差异(P>0.05)。结论UF-4000型全自动尿液有形成分分析仪操作简便,报告时限较短,能够快速且精准地对UTI进行诊断,并能为临床用药提供有效及时的指导,建议临床推崇使用。在原有检测项目基础上增加了细菌定量检测、细菌革兰染色分型及UTI提示信息。     

UF-1000i尿沉渣分析仪在尿路感染诊断的评价

目的评价UF-1000i尿沉渣分析仪在尿路感染中诊断的价值。方法采集我院377例尿感患者尿液并进行分析,同时设立阴性对照组并进行比较。以尿定量培养为金标准,计算出UF-1000i在细菌性、真菌性尿路感染测定的灵敏度,特异度,阳/阴预测值和假阳性/假阴性率,准确率。结果 UF-1000i在细菌性和真菌性尿路感染细菌测定的敏感度,特异度,阳性预期值,阴性预期值,假阳性率,假阴性率,准确度分别为:83.07,81.88,80.84,84.01,18.12,16.93,82.45(细菌性尿路感染)及89.47,87.72,87.93,89.29,12.28,10.53,88.60(真菌性尿路感染)。结论 UF-1000i尿沉渣分析仪在尿路感染中诊断有重要价值,尤其是真菌性尿路感染。     

UF-1000i尿液有形成分分析仪对尿路感染诊断的价值

目的探讨UF-1000i尿液有形成分分析仪在患者尿路感染诊断中的应用价值。方法用UF-1000i检测652例疑似尿路感染（UIT）患者中段尿中的细菌数,以定量尿细菌培养作为诊断尿路感染的金标准,应用ROC曲线确立最佳临界值,评价UF-1000i诊断尿路感染的敏感度、特异度、阳性预测值、阴性预测值和准确度。结果 UF-1000i分析仪细菌计数诊断患者尿路感染的cut-off值为1 630个/微升,其敏感度、特异度、阳性预测值、阴性预测值、准确度分别为84.0%、81.0%、42.9%、90.8%、79.3%。结论 UF-1000i分析仪可作为患者尿路感染的快速筛查工具。     

评价UF-500i尿沉渣分析仪在诊断尿路感染中的应用

目的 探讨UF-500i尿沉渣分析仪对尿路感染诊断的价值.方法 采集该院345例门诊、住院患者清洗外阴后取中段尿,使用UF-500i尿沉渣分析仪测定尿液白细胞和细菌数,同时进行尿液的细菌培养,以细菌培养结果为金标准,并以大于或等于10×105 CFU(集落形成单位 colony-forming units)/mL 为阳性诊断标准.利用SPSS13.0统计软件绘制受试者工作特征ROC曲线,从而计算出白细胞和细菌数在尿路感染的诊断阈cut off值,得出其灵敏度、特异性、阴/阳性预测值和假阳性/阴性率.结果 尿培养结果阳性的标本96例(27.8%),得出细菌数和白细胞数cut off值分别为130.2个/μL和29.8个/μL,其联合测定对尿路感染诊断的灵敏度,特异度,假阳性率,假阴性率分别为73.58%,95.20%,26.42%,4.80%.结论 UF-500i尿沉渣分析仪是一种简单快速、可靠的尿液筛查实验,其细菌和白细胞计数可以作为尿路感染诊断检测的良好指标.     

UF-1000i全自动尿液有形成分分析仪性能评价

目的评价UF-1000i全自动尿液有形成分分析仪（简称UF-1000i）的性能。方法参照美国临床实验室标准化协会（CLSI）H56-A文件及UF-1000i病例研究手册的性能评价方法对该仪器的5个定量分析参数的批内精密度、批间精密度、携带污染率、线性范围、不准确度、与镜检符合率等性能进行评价。结果白细胞（WBC）、红细胞（RBC）、上皮细胞（EC）、管型（CAST）、细菌（BACT）的批内精密度分别为1.37%～8.67%、0.57%～6.26%、2.89%～11.16%、6.15%～30.18%、1.74%～8.46%;批间精密度分别为1.60%～6.96%、2.66%～4.72%、6.06%～15.83%、6.85%～16.01%、4.31%～5.56%;线性范围分别为0.7～4 577、4.6～12 638、1.63～70.9、1.42～17.5、9.5～22 322个/μL,线性相关系数（r）分别为0.999 9、0.999 9、0.999 9、0.999 2、0.999 9;不准确度分别为0.74%～9.80%、0.25%～5.18%、7.10%～29.14%、3.91%～26.44%、0.14%～10.26%;WBC、RBC、BACT的携带污染率分别为0.04%、0.03%、0.01%;WBC、RBC、EC、CAST、病理管型（P.CAST）与镜检符合率分别为83.5%、85.8%、97.5%、64.3%、63.3%,Kappa值分别为0.246、0.269、0.291、0.018、-0.024。结论 UF-1000i的5个定量分析参数的批内精密度、批间精密度、携带污染率、线性范围、不准确度等指标与厂商的说明书性能相符合;与镜检符合率方面,因规范尿液离心镜检目测法不适用于尿沉渣有形成分定量,按厂商提供方法得到的符合率较高,而经Kappa检验所得结果的一致性较差。     

The Prevalence of Urinary Tract Infections and Sexually Transmitted Disease in Women with Symptoms of a Simple Urinary Tract Infection Stratified by Low Colony Count Criteria

OBJECTIVES: Urinary tract infections (UTIs) and early pelvic infections due to sexually transmitted disease (STD) may cause similar symptoms. Therefore, a simple history and urine dip to establish a diagnosis of UTI may result in overtreatment of UTIs and undertreatment of STDs. The objective of this study was to determine the proportion of women with symptoms suggestive of a UTI who are urine culture positive versus urine culture negative, the prevalence of STDs between groups, and if elements of the history or examination may predict those requiring STD screening. METHODS: This was a prospective cohort study in an urban emergency department. Women 18-55 years of age with urinary frequency, urgency, dysuria, and no new vaginal discharge or change in discharge were enrolled. The following were performed: detailed history; bladder catheterization for urinalysis, urine dip, and urine culture; pelvic examination and cervical samples for gonorrhea and Chlamydia trachomatis DNA ligase; and wet mount examinations. Main outcome measurements were the percentage of women who were urine culture positive (using low count criteria of 10(2) colony-forming units [CFU]/mL), the proportion of STDs between urine culture groups, and univariate analysis and logistic regression of historical and examination elements. RESULTS: Ninety-two patients were enrolled; the mean age was 26 years (range, 18-51 years). All had samples for DNA ligase (one quantity not sufficient) and urinalysis or urine dip, while 75 of 92 had urine cultures performed. A total of 57.3% (43/75) were urine culture positive at 10(2) CFU/mL, while the STD rate for those with urine cultures was 17.3% (13/75). There was no statistically significant difference in the number of STDs between urine culture positive and urine culture negative groups. The only variable on logistic regression predictive of an STD (based on all 91 patients) was more than one sex partner in the past year (p = 0.013). No other element of the history or pelvic examination helped differentiate those who tested positive for an STD. CONCLUSIONS: A total of 17.3% of women with symptoms of a UTI in this study had an STD, while only 57.3% were urine culture positive by catheterization using low count criteria. The proportion of STDs between those with and without a UTI was not significantly different.     

武汉地区泌尿道感染病原菌的分布及耐药性分析

目的：调查武汉地区泌尿道感染病原菌的分布及耐药情况,为诊断和治疗泌尿道感染提供可靠依据。方法对2012年1月1日～2014年6月30日武汉大学人民医院泌尿道感染患者尿培养分离出的5378株病原菌的分布及耐药性进行回顾性分析,使用BD Pheonix-100进行细菌的鉴定及药敏,真菌使用显色平板进行分离鉴定。结果泌尿系感染患者尿液培养分离出病原菌5378株,共104种,其中革兰阴性菌2945株,占54.8％,以大肠埃希菌为主;革兰阳性菌1657株,占30.8％,以肠球菌属为主;真菌776株,占14.4％。主要分离菌对抗生素的耐药情况不同：大肠埃希菌对青霉素的耐药率最高,均＞83％,未发现碳青霉烯类耐药菌株;发现对万古霉素和利奈唑胺耐药的肠球菌,耐药率均在0.3％以上;MRCNS的检出率＞83％。结论泌尿系感染病原菌中以大肠埃希菌最常见。β-内酰胺酶抑制剂复合制剂可作为大肠埃希菌感染的经验性用药;MRCNS检出率增高,应引起密切关注。     

Factors Provoking Lower Urinary Tract Infection in Women

Our aim was to evaluate possible risk factors, other than sexual activity, for urinary tract infection (UTI) in women. A case-control study was designed. 50 cases and 50 controls were included.

A larger fraction of cases than controls reported that episodes of the following preceded the UTI: voluntary deferred voiding (Odds ratio 5.0, 95% confidence interval 1.7; 20.1), cold hands (4.7, 1.3; 25.3), cold feet (5.8, 2.0; 22.8), and cold buttocks (5.5, 1.2; 51.0).

Cold body parts should be further evaluated as a possible risk factor for UTI in UTI-prone women.     

泌尿系统医院感染的调查分析与防治对策

目的探讨我院泌尿系统医院感染的现状和对策。方法以回顾性调查方法对我院共8576份出院病例中发生泌尿系统医院感染115例进行统计分析。结果我院泌尿系统医院感染发生率为1．34％,居全院医院感染部位发生率第2位。我院泌尿系统医院感染与泌尿系统插管、糖尿病、血尿、免疫抑制剂使用等危险因素有密切关系。两项危险因素集中于同一病例时,泌尿系统医院感染的发生率将显著增高。泌尿系统医院感染病例与非泌尿系统医院感染病例尿细菌培养结果比较,真菌与肠球菌有统计学差异。结论针对危险因素采取措施,严密监测与控制泌尿系统真菌与肠球菌感染,以降低泌尿系统医院感染率。     

Female Patient Self-diagnosis Compared With Emergency Physician Diagnosis of Urinary Tract Infection

Background

Urinary tract infection (UTI) is a common emergency department (ED) complaint and self-diagnosis may be possible.

Objective

The objective was to compare female patient self-diagnosis compared with emergency physician (EP) diagnosis of UTI.

Methods

This was a prospective cohort study in a single urban ED. Women aged 18–64 years with a chief complaint of UTI, urinary frequency, or dysuria who presented to an urban academic ED were enrolled in a convenience sample fashion. Patients completed a written four-question survey by an ED greeter before triage. Charts of respondents were reviewed for demographic, laboratory, and EP diagnosis.

Results

Fifty women were enrolled; 100% of patients who were approached participated in the study. Mean age was 33.7 years (standard deviation 13.8). Forty-three patients (86%) had a history of UTI. Forty-one patients (82%) thought they had a UTI on the index visit. Thirty patients (60%) preferred to buy over-the-counter antibiotics for their symptoms instead of seeing a doctor. Fifteen patients (30%) identified a specific antibiotic they would take. Of the 41 patients who thought they had a UTI, 25 (61%) were given that diagnosis. Of the 30 patients who would have preferred over-the-counter antibiotics, 20 (67%) were actually prescribed them. Agreement between EP and women's final impressions was low (κ = 0.11).

Conclusions

There was poor agreement between EP diagnosis and self-diagnosis of UTI. In our ED population, women should be encouraged to seek medical attention to confirm the diagnosis.     

老年患者留置尿管致尿路感染的原因及对策

目的探讨老年住院患者留置尿管致尿路感染的相关因素,寻求有效的预防措施,以减少尿路感染的发生。方法对176例留置尿管的老年住院患者进行目标性监测,对其中发生尿路感染的患者就其相关因素进行分析。结果 176例留置尿管患者中有39例发生尿路感染,感染率为22.16%。女性明显高于男性(P<0.05﹚,留置尿管时间越长感染率越高(P<0.05﹚,不同基础疾病患者尿路感染发生率差异有统计学意义(P<0.05﹚。39例尿路感染共检出病原菌32株,其中以大肠埃希菌为主,占37.50%。结论老年患者尿路感染的发生与性别、基础疾病、尿管留置时间有关;加强尿路感染高发人群的目标性监测,针对易感因素制定相关干预措施,可降低其发生率。     

留置导尿致尿路感染的原因分析及对策

目的研究留置导尿中预防和控制尿路感染的护理对策。方法预防尿路感染的最好办法就是严格掌握导尿指征,向患者说明导尿的目的及配合要领。留置导尿后,严格执行无菌技术进行尿管护理,尽量缩短留置导尿时间并合理使用抗生素,此外,对患者及家属也要进行预见性护理,使其了解必要的留置尿管知识。结果严格掌握导尿指征及无菌操作原则,可使尿路感染的机会降低到最低限度。结论高度的责任心与行之有效的护理措施及耐心的心理指导,能明显降低尿路感染的发生机会,从而减轻患者的痛苦。     

The Presence of Urinary Nitrites Is a Significant Predictor of Pediatric Urinary Tract Infection Susceptibility to First- and Third-Generation Cephalosporins

Background: Previous studies in adults have refuted the use of nitrites as a predictor of bacterial resistance to both trimethoprim-sulfamethoxazole and cephalosporins. Some centers now consider first-line outpatient therapy with an oral third-generation cephalosporin appropriate for young children. Objective: The objective of this study was to determine if nitrite-negative pediatric urinary tract infections (UTIs) were more likely than nitrite-positive UTIs to be resistant to cephalosporins. This may enable physicians to adjust antimicrobial therapy before patients leave the Emergency Department (ED) to avoid the complications of ineffectively treated pediatric UTIs. Methods: A retrospective chart review examined, over a 9-month period, 173 pediatric patients who were diagnosed with a clinical UTI in the ED and who also had a positive urine culture and a recorded dipstick at the time of visit. The chi-squared test and Fisher's exact test were used to compare nitrite-negative vs. nitrite-positive UTIs for resistance to third-generation cephalosporins and other empiric antimicrobials. Results: For third-generation cephalosporins, 1.4% of nitrite-positive UTIs were resistant, whereas 14.4% of nitrite-negative UTIs were resistant (95% confidence interval [CI] −0.22 to −0.05). For first-generation cephalosporins, 8.4% were resistant in the nitrite-positive group, compared to 22.2% in the nitrite-negative group (95% CI −0.24 to −0.03). Conclusion: The absence of urinary nitrites is a significant indicator for potential resistance to cephalosporins in pediatric UTIs. Due to low levels of pediatric UTI resistance, cephalosporins continue to represent useful empiric therapy in the general pediatric population. However, in high-risk patients, physicians may opt to alter their empiric choice of antibiotic based on the presence of urinary nitrites.     

不同抗生素治疗下泌尿道感染的成本-效果分析

目的：评价不同抗生素治疗下泌尿道感染的成本和疗效。方法：将98例下泌尿道感染病人随机分成两组。分别接受头孢噻肟和对照药物治疗，并对治疗方案的成本-效果进行分析。结果：头孢噻肟和对照药物治疗下泌尿道感染的效果基本相同，没有显著性差异（p〉0．05），药物治疗成本之间存在显著性差异（p〈0．05）。结论：与头孢噻肟相比，对照药物治疗下泌尿道感染的成本-效果较好。