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Related Experiment Videos

Quantification of pyuria by two methods correlation and interobserver agreement.

A Baerheim1, G Albrektsen, A G Eriksen

  • 1Institute of General Practice, University of Bergen, Norway.

Scandinavian Journal of Primary Health Care
|June 1, 1989
PubMed
Summary

Quantifying pyuria using high-power-field (HPF) microscopy on centrifuged urine sediment is a reliable routine method. This method correlates well with the Bürker haemocytometer, offering high interobserver agreement for diagnosing urinary tract infections.

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Area of Science:

  • Urology
  • Clinical Chemistry
  • Microbiology

Background:

  • Accurate quantification of pyuria is crucial for diagnosing urinary tract infections (UTIs).
  • Two common methods for quantifying pyuria include microscopy of urine sediment and haemocytometer counting.
  • Interobserver agreement is essential for reliable diagnostic methods.

Purpose of the Study:

  • To correlate results from high-power-field (HPF) microscopy and Bürker haemocytometer for pyuria quantification.
  • To compare the diagnostic reliability and interobserver agreement of these two methods.

Main Methods:

  • Three independent observers analyzed 56 urine samples.
  • Leukocyte counts were performed using HPF microscopy on centrifuged urine sediment.
  • Leukocyte counts were also performed using a Bürker haemocytometer on uncentrifuged urine.

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  • Interobserver agreement was evaluated using Kappa statistics.

    • Main Results:

    • A haemocytometer level of 10 leucocytes/mm³ was equivalent to 2 leucocytes/HPF.
    • This finding contrasts with the commonly assumed diagnostic threshold of 5-10 leucocytes/HPF.
    • High interobserver agreement was observed for both methods (96% for haemocytometer, 93-96% for HPF microscopy).
    • Kappa values indicated strong agreement for both methods (K=0.92 for haemocytometer, K=0.81-0.91 for HPF microscopy).

    Conclusions:

    • HPF microscopy of centrifuged urine sediment is a reliable and suitable method for routine pyuria quantification in general practice.
    • The diagnostic threshold for UTIs should be reconsidered, as less than 5 leucocytes/HPF may not rule out infection in symptomatic patients.
    • Both methods demonstrate good interobserver agreement, supporting their use in clinical settings.