PDF(Pubmed)
Abstract：
Urinary tract infections (UTIs) are a leading infectious cause of emergency department admission. Early UTI diagnosis is challenging, and a faster, preferably point-of-care urine analysis is necessary. We aimed to evaluate the diagnostic accuracy of urine flow cytometry (UFC) and urine dipstick analysis (UDA) in identifying bacteriuria and UTIs. This study included adults suspected of an infection admitted to three Danish emergency departments. UFC and UDA were the index tests, and urine culture and an expert panel diagnosis were the reference tests. We used logistic regression and receiver operator characteristics curves to find each test\'s optimal model and cut-off. We enrolled 966 patients and performed urine cultures on 786. Urine culture was positive in 337, and 200 patients were diagnosed with a UTI. The UFC model ruled out bacteriuria in 10.9% with a negative predictive value (NPV) of 94.6% and ruled out UTI in 38.6% with an NPV of 97.0%. UDA ruled out bacteriuria in 52.1% with an NPV of 79.2% and UTI in 52.8% with an NPV of 93.9%. Neither UFC nor UDA performed well in ruling out bacteriuria in our population. In contrast, both tests ruled out UTI safely and in clinically relevant numbers.
摘要：
尿路感染（UTI）是急诊科入院的主要传染性原因。早期UTI诊断具有挑战性，更快,最好是即时尿液分析是必要的。我们旨在评估尿液流式细胞术（UFC）和尿液试纸分析（UDA）在识别菌尿和UTI中的诊断准确性。这项研究包括三个丹麦急诊科收治的疑似感染的成年人。UFC和UDA是指标测试，尿液培养和专家小组诊断是参考测试。我们使用逻辑回归和接收器算子特征曲线来找到每个测试的最佳模型和截止值。我们招募了966名患者，并在786名患者进行了尿液培养。337例尿液培养阳性，200例患者被诊断为UTI。UFC模型排除了10.9％的细菌尿症，阴性预测值（NPV）为94.6％，排除了38.6％的UTI，NPV为97.0％。UDA排除了52.1％的细菌尿症，NPV为79.2％，UTI为52.8％，NPV为93.9％。UFC和UDA在排除我们人群中的菌尿方面均未表现良好。相比之下,两项测试均安全排除了UTI,并排除了临床相关数据.
