尿沉渣镜检与干化学分析在筛选儿童泌尿系感染中的应用

    Urine dipstick screen test and microscopic examination for detection of urinary tract infection in children

    • 摘要: 目的: 探讨尿沉渣镜检及干化学分析在筛选儿童泌尿系统感染中的可靠性。方法: 收取合格中段尿,取10 μl做细菌培养及菌落计数,剩余标本做干化学分析,主要检测白细胞酯酶(LE)、亚硝酸盐(NIT)及沉渣镜检。结果: 共检测中段尿标本109份,其中23例培养出有意义细菌(菌落计数≥105CFU/ml),阳性率为21.1%。尿沉渣镜检、干化学分析的敏感性分别为73.9%和82.6%,特异性分别为95.3%、88.4%。另有4例培养阳性,干化学分析阴性,假阴性率为17.4%;4例沉渣镜检阳性,培养阴性,假阳性率为19.3%;尿沉渣镜检、干化学分析的阳性预示值(PPV)分别为81.0%和65.5%。结论: 尿沉渣镜检、干化学分析作为单一参数在筛选泌尿系统感染时敏感性不足,必要时仍须做细菌培养。

       

      Abstract: Objective: To compare the reliability of microscopic examination and urine dipstick evaluation with the urine culture in diagnosing urinary tract infection(UTI) in children.Methods: Fresh midstream clean-catch urine samples were collected in accordiance with standard guideline,10 μl of the urine specimen was used for bacteria culture(colony counts of ≥ 105 CFU/ml),the other portion was used for test with reagent strip for presence of LE,NIT and microscopic examination.Results: One hundred and nine samples were tested in all,23 patients(21.1%) had bacteria cultures of 100 000 or more colony-forming units of a uropathogen per milliliter.The sensitivities of the microscopic examination and dipstick test in identifying patients with positive cultures were 73.9% and 82.6%,and the specificities were 95.3% and 88.4%,respectively.Four patients(17.4%) had negative dipstick screening tests but positive urine cultures,and other four patients had positive microscopic examination but negative urine cultures.The positive predict value(PPV) of urine microscopic examination and dipstick evaluation was 81.0% and 65.5% respectively.Conclusions: Urine reagent strips tests and microscopic examination are not sufficiently sensitive in the detection of UTI;therefore,bacteria culture must be adopted.

       

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