高齢者におけるバクテリウリアの診断のための白血球エステラーゼとニートリート検査の精度: 系統的レビューとメタ解析
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PubMedで要約を見る
まとめ
この要約は機械生成です。高齢者におけるバクテリウリアと尿路感染症の検査は信頼できない. 陽性な結果は不確実であり,この集団におけるUTIの診断のためにこれらの検査を中止することを示唆する.
科学分野
- 高齢者医療
- 診断 の 正確 さ
- 微生物学
背景
- 尿量計は,バクテリウリアと尿路感染症 (UTI) の診断に広く使用されています.
- 高齢者はしばしば無症状のバクテリアウリアを発症し,尿路感染症の診断を複雑にします.
- この集団における測定棒の精度は 徹底的な評価を必要とする.
研究 の 目的
- 60歳以上の個体におけるバクテリアウリアの診断精度 (白血球エステラゼおよび/またはニトリート) を体系的に検討し,メタ分析する.
- 症状性尿路感染症の診断とバクテリアウリアの診断の精度を比較する.
- 高齢者集団における測定棒の使用に関する臨床実務を伝えるため
主な方法
- 診断精度研究の体系的レビューとランダム効果メタ解析
- 言語の制限なしに,前向きな観察コホートとケース・コントロールの研究を含む.
- バイアスのリスクの評価の基準として尿培養とQUADAS-2を使用する.
主要な成果
- 中程度のバイアスのリスクで,16件の試験が含有基準を満たした.
- バクテリウリアに対するプールの感度は90% (95%CI,84-94%) であり,特異性は56% (43-68%) であった.
- 症状のある高齢者では,尿路感染症に対する感度が92% (76~97%) であり,特異性は39% (19~62%) であった.
結論
- 尿検査の陽性な結果は,高齢者のバクテリアウリアまたは尿道感染症の診断には決定的ではありません.
- 細菌尿は,無症状症例の高頻度のため,この集団において診断価値が限られている.
- 高齢者における尿路感染症の診断のためのダイプスティック検査の中止は,これらの発見によって支持されています.
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