PDF(Pubmed)
Abstract：
UNASSIGNED: The diagnostic utility of point-of-care (POC) Gram stains for obstructive pyelonephritis with hydronephrosis is not well established. The current study aimed to assess the diagnostic accuracy of urine Gram stains in patients with obstructive pyelonephritis due to ureteral stones.
UNASSIGNED: A retrospective observational study was conducted on patients with obstructive pyelonephritis admitted to our hospital between January 2011 and December 2021. The diagnostic accuracy of Gram stains was evaluated based on the severity of hydronephrosis, including Gram stains performed by both trained physicians and microbiological technicians.
UNASSIGNED: After analyzing 210 patients, POC Gram stains of bladder urine presented a sensitivity, specificity, positive predictive value, and negative predictive value of 86.8%, 81.8%, 93.7%, and 66.7%, respectively, for gram-negative rods and 65.7%, 83.4%, 48.9%, and 91.0%, respectively, for gram-positive cocci. The agreement between POC Gram stains and urine culture was good for gram-negative rods, with a kappa (κ) coefficient of 0.637 and agreement rate of 85.6%, and moderate for gram-positive cocci, with a κ coefficient of 0.435 and agreement rate of 80%. The agreement between POC Gram stains and bladder urine culture results for gram-negative rods was higher in the mild hydronephrosis group (κ coefficient = 0.677) than in the severe hydronephrosis group (κ coefficient = 0.466). Discrepancies in Gram stain results between physicians and technicians were observed in 21 of 180 cases (11.7%).
UNASSIGNED: POC Gram stains for gram-negative rods may be a useful diagnostic tool for obstructive pyelonephritis, particularly in cases of mild hydronephrosis.
UNASSIGNED: A retrospective observational study was conducted on patients with obstructive pyelonephritis admitted to our hospital between January 2011 and December 2021. The diagnostic accuracy of Gram stains was evaluated based on the severity of hydronephrosis, including Gram stains performed by both trained physicians and microbiological technicians.
UNASSIGNED: After analyzing 210 patients, POC Gram stains of bladder urine presented a sensitivity, specificity, positive predictive value, and negative predictive value of 86.8%, 81.8%, 93.7%, and 66.7%, respectively, for gram-negative rods and 65.7%, 83.4%, 48.9%, and 91.0%, respectively, for gram-positive cocci. The agreement between POC Gram stains and urine culture was good for gram-negative rods, with a kappa (κ) coefficient of 0.637 and agreement rate of 85.6%, and moderate for gram-positive cocci, with a κ coefficient of 0.435 and agreement rate of 80%. The agreement between POC Gram stains and bladder urine culture results for gram-negative rods was higher in the mild hydronephrosis group (κ coefficient = 0.677) than in the severe hydronephrosis group (κ coefficient = 0.466). Discrepancies in Gram stain results between physicians and technicians were observed in 21 of 180 cases (11.7%).
UNASSIGNED: POC Gram stains for gram-negative rods may be a useful diagnostic tool for obstructive pyelonephritis, particularly in cases of mild hydronephrosis.
摘要：
■对梗阻性肾盂肾炎伴肾积水的即时护理（POC）革兰氏染色的诊断效用尚不明确。本研究旨在评估输尿管结石所致梗阻性肾盂肾炎患者尿液革兰氏染色的诊断准确性。
■对2011年1月至2021年12月我院收治的梗阻性肾盂肾炎患者进行了一项回顾性观察性研究。根据肾积水的严重程度评估革兰氏染色的诊断准确性，包括由受过培训的医生和微生物技术人员进行的革兰氏染色。
■分析210例患者后，膀胱尿液的POC革兰氏染色表现出敏感性，特异性，正预测值，阴性预测值为86.8%，81.8%,93.7%,和66.7%，分别,革兰氏阴性棒和65.7%，83.4%,48.9%,91.0%，分别,革兰氏阳性球菌.对于革兰氏阴性棒，POC革兰氏染色和尿液培养之间的一致性很好，Kappa(κ)系数为0.637，一致率为85.6%，中度革兰氏阳性球菌，κ系数为0.435，一致率为80%。轻度肾积水组（κ系数=0.677）与重度肾积水组（κ系数=0.466）相比，革兰阴性棒的POC革兰氏染色与膀胱尿培养结果的一致性更高。180例中有21例（11.7％）观察到医师和技术人员之间的革兰氏染色结果差异。
■用于革兰氏阴性棒的POC革兰氏染色可能是阻塞性肾盂肾炎的有用诊断工具，特别是在轻度肾积水的情况下。
■对2011年1月至2021年12月我院收治的梗阻性肾盂肾炎患者进行了一项回顾性观察性研究。根据肾积水的严重程度评估革兰氏染色的诊断准确性，包括由受过培训的医生和微生物技术人员进行的革兰氏染色。
■分析210例患者后，膀胱尿液的POC革兰氏染色表现出敏感性，特异性，正预测值，阴性预测值为86.8%，81.8%,93.7%,和66.7%，分别,革兰氏阴性棒和65.7%，83.4%,48.9%,91.0%，分别,革兰氏阳性球菌.对于革兰氏阴性棒，POC革兰氏染色和尿液培养之间的一致性很好，Kappa(κ)系数为0.637，一致率为85.6%，中度革兰氏阳性球菌，κ系数为0.435，一致率为80%。轻度肾积水组（κ系数=0.677）与重度肾积水组（κ系数=0.466）相比，革兰阴性棒的POC革兰氏染色与膀胱尿培养结果的一致性更高。180例中有21例（11.7％）观察到医师和技术人员之间的革兰氏染色结果差异。
■用于革兰氏阴性棒的POC革兰氏染色可能是阻塞性肾盂肾炎的有用诊断工具，特别是在轻度肾积水的情况下。
