尿液显微镜和尿液培养在没有定位尿路特征的细菌性成年人的预测价值
Nicholas Young1, Jenna Beaumont2, Alexandra Maling1
1Infectious Diseases Service, Te Whatu Ora Counties Manukau, Auckland, New Zealand.
Internal medicine journal
|October 22, 2024
概括
细菌性尿路感染 (bUTI) 即使没有明显的尿路症状也很常见. 尿液显微镜和培养具有很高的负预测价值,可以在感染源不清楚时排除bUTI.
科学领域:
- 传染性疾病 传染性疾病
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 诊断微生物学 诊断微生物学
背景情况:
- 尿液显微镜 (UM) 和尿液培养 (UC) 是识别细菌性患者尿道感染源的标准.
- 在缺乏明显尿路症状的患者中,UM/UC的诊断准确性是不确定的.
研究的目的:
- 评估UM/UC的预测价值,用于在没有局部化尿路特征的细菌性患者中诊断细菌性尿路感染 (bUTI).
- 评估不清楚或怀疑非尿道感染源的子组的UM/UC表现.
主要方法:
- 对871名细菌性成年人的回顾性分析.
- 确定了UM/UC的正预测值 (PPV) 和负预测值 (NPV).
- 对不清楚焦点与疑似非尿性焦点的患者进行亚组分析.
主要成果:
- 32.2%的bUTI病例缺乏局部化尿路特征.
- 在不清楚的焦点情况下:UM PPV 51.5%,NPV 96%;UC PPV 75%,NPV 88.6%.
- 在怀疑的非尿焦点病例中:UM PPV 5.2%,NPV 100%;UC PPV 25%,NPV 99.5%.
结论:
- bUTI是经常发生的,没有明显的尿路症状.
- 在不清楚的感染病例中排除bUTI的UM/UC具有高的NPV,但有限的PPV.
- 在怀疑非尿道感染时,UM/UC的诊断收益率较低.
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