Abstract：
BACKGROUND: Qualitative urinalysis using the Sternheimer stain is a common method in Japan for identifying bacteriuria, but there is a lack of studies examining its test characteristics. In this study, we aimed to investigate the sensitivity and specificity of the Sternheimer stain for urine culture results and compare it with the sensitivity and specificity of the Gram stain. Our goal was to determine the usefulness of the Sternheimer stain in identifying bacteriuria.
METHODS: Among 986 patients aged 16 years or older from whom samples for both urinalysis and urine culture were obtained at the emergency room of Tenri Hospital from January 2019 to December 2019, 342 patients with pyuria, defined as the presence of 10 or more white cells per cubic millimeter in a urine specimen, who had not received prior antimicrobial therapy were included. Urine cultures were used for comparison to determine the sensitivity and specificity of Sternheimer and Gram stain in this patient group. A positive Sternheimer stain result was defined as bacteriuria ≥ (1+), and that of Gram stain was defined as ≥ 1/1 field of high-power ( × 1000) oil immersion.
RESULTS: Using urine culture results for comparison, the sensitivity of Sternheimer stain was 92.2%, the specificity was 48.5%, the positive likelihood ratio was 1.79, and the negative likelihood ratio was 0.16.
CONCLUSIONS: Sternheimer stain is a rapid and useful method to exclude bacteriuria in a group of patients with pyuria in the emergency department.
METHODS: Among 986 patients aged 16 years or older from whom samples for both urinalysis and urine culture were obtained at the emergency room of Tenri Hospital from January 2019 to December 2019, 342 patients with pyuria, defined as the presence of 10 or more white cells per cubic millimeter in a urine specimen, who had not received prior antimicrobial therapy were included. Urine cultures were used for comparison to determine the sensitivity and specificity of Sternheimer and Gram stain in this patient group. A positive Sternheimer stain result was defined as bacteriuria ≥ (1+), and that of Gram stain was defined as ≥ 1/1 field of high-power ( × 1000) oil immersion.
RESULTS: Using urine culture results for comparison, the sensitivity of Sternheimer stain was 92.2%, the specificity was 48.5%, the positive likelihood ratio was 1.79, and the negative likelihood ratio was 0.16.
CONCLUSIONS: Sternheimer stain is a rapid and useful method to exclude bacteriuria in a group of patients with pyuria in the emergency department.
摘要：
背景：使用Sternheimer染色法进行定性尿液分析是日本鉴定细菌尿的常用方法，但是缺乏研究其测试特征。在这项研究中,我们旨在研究Sternheimer染色对尿培养结果的敏感性和特异性，并将其与革兰氏染色的敏感性和特异性进行比较。我们的目标是确定Sternheimer染色在鉴定细菌尿中的有用性。
方法：在2019年1月至2019年12月在Tenri医院急诊室获得尿液分析和尿液培养样本的986名年龄在16岁以上的患者中，有342名患者出现脓尿，定义为尿液样本中每立方毫米存在10个或更多的白细胞，纳入了之前未接受过抗菌治疗的患者.尿液培养物用于比较，以确定该患者组中Sternheimer和革兰氏染色的敏感性和特异性。阳性Sternheimer染色结果定义为细菌尿症≥(1+)，将革兰氏染色定义为大功率（×1000）浸油≥1/1场。
结果：使用尿液培养结果进行比较，Sternheimer染色的灵敏度为92.2%,特异性为48.5%，阳性似然比为1.79,阴性似然比为0.16.
结论：Sternheimer染色是一种快速有效的方法，可以排除急诊科一组脓尿患者的菌尿。
方法：在2019年1月至2019年12月在Tenri医院急诊室获得尿液分析和尿液培养样本的986名年龄在16岁以上的患者中，有342名患者出现脓尿，定义为尿液样本中每立方毫米存在10个或更多的白细胞，纳入了之前未接受过抗菌治疗的患者.尿液培养物用于比较，以确定该患者组中Sternheimer和革兰氏染色的敏感性和特异性。阳性Sternheimer染色结果定义为细菌尿症≥(1+)，将革兰氏染色定义为大功率（×1000）浸油≥1/1场。
结果：使用尿液培养结果进行比较，Sternheimer染色的灵敏度为92.2%,特异性为48.5%，阳性似然比为1.79,阴性似然比为0.16.
结论：Sternheimer染色是一种快速有效的方法，可以排除急诊科一组脓尿患者的菌尿。
