Bir İkinci Basamak Sağlık Merkezinde Tam İdrar Tetkikinin Performansının Değerlendirilmesi
Küçük Resim Yok
Tarih
2017
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: İdrar yolu enfeksiyonu (İYE) tanısında altın standart olan idrar kültürü tam idrar tetkikine (TİT) göre yüksek maliyet, iş gücü ve zaman gerektirmektedir. Bu nedenle laboratuvarların kendi uyguladıkları TİT'in kültür sonucunu öngörebilme performansını değerlendirmeleri önemlidir. Çalışmamızın amacı laboratuvarımızda, idrar kültürü sonuçlarını referans alarak, strip ile değerlendirilen lökosit, eritrosit, nitrit ile mikroskobik olarak değerlendirilen lökosit ve eritrosit testlerinin performansını ortaya koymaktır. Gereç ve Yöntem: Kemalpaşa Devlet Hastanesi Merkez Laboratuvarı'nda 6 aylık dönemde idrar kültürü ve TİT yapılan İYE ön tanılı hastalar çalışmaya alındı. Kültür sonuçları referans alınarak strip ile değerlendirilen lökosit, eritrosit, nitrit ile mikroskobik olarak değerlendirilen lökosit ve eritrosit testlerinin performansı değerlendirildi. Duyarlılık, özgüllük, pozitif (PV+), negatif öngörü değeri (PV-), pozitif (LR+) ve negatif olabilirlik oranı (LR-) hesaplandı. Değerlendirilen testler ile kültür sonuçları arasındaki ilişki lojistik regresyon ile analiz edildi. Bulgular: Aynı gün kültür ve TİT çalışılan 606 örneğin 513'ünde (%84,6) üreme saptanmadı. Duyarlılık; en yüksek strip lökosit (eser) (%93,5), en düşük strip eritrosit (3+) (%25,8), özgüllük; en yüksek nitrit (%98,2), en düşük strip lökosit (eser) (%51,2) testlerinde bulundu. En yüksek PV+ değeri nitrit (86,4), PV- değeri strip lökosit (eser) (%97,8) ile mikroskobi lökosit (97,4) testlerinde bulundu. LR+ değeri nitrit testinde 34,9, diğer tüm testlerde <10 olarak hesaplandı. LR- değeri en küçük mikroskobi lökosit ve strip lökosit (eser) testlerinde sırası ile 0,15 ve 0,13 idi. Diğer değişkenler sabit tutulduğunda nitrit pozitifliğinde kültürde anlamlı üreme olma riskinin 45 kat arttığı bulundu. Sonuç: İYE ön tanılı hastalarda kültür istemi öncesinde TİT'de nitrit ve strip lökosit testlerinin beraber değerlendirilmesinin kültür sonucunu öngörmedeki yararı nedeni ile gereksiz yapılabilecek kültür testlerinin azalmasına katkı sağlayabileceğini düşünmekteyiz
Objective: Urine culture test (UCT), which is the gold-standard for urinary tract infections (UTI), requires higher cost, labour and time than complete urinalysis (CU). Therefore, it is important to assess prediction performance of CU's for UCT. the aim of our study is to demonstrate performance of strip leukocyte, erythrocyte, nitrite, microscopic leukocyte and microscopic erythrocyte tests in relation with UCT. Material and Methods: Patients which had CU, UCT requests and UTI pre-diagnosis in Kemalpasa State Hospital Central Laboratory during 6 months’ period were included. Performance of strip leukocyte, erythrocyte, nitrite, microscopic leukocyte and erythrocyte tests was evaluated with reference to UCT. Sensitivity, specificity, PV+, PV-, LR+ and LR- values were calculated. Relationship between assessed tests and UCT was analysed by logistic-regression. Results: of 606 samples with CU and UCT request on the same day, UCT positivity was not detected in 513 (84,6%). Sensitivity was highest for strip leukocyte (trace) (93,5%), and lowest for strip erythrocyte (3+) (25,8%), and specificity was highest for nitrite (98,2%) and lowest for strip leukocyte (trace) (51,2%). Highest PV+ was in nitrite (86,4%) and highest PV- was in microscopic leukocyte (97,4%) and strip leukocyte (trace) (97,8%) tests. LR+ was calculated as 34,9 for nitrite and <10 for others. Smallest LR- values for microscopic leukocyte and strip leukocyte (trace) tests were found to be 0,15 and 0,13 respectively. in nitrite positivity, risk of significant growth in UCT increased by 45 times. Conclusion: We conclude that combined evaluation of nitrite and strip leukocyte tests in CU before UCT request may contribute to the reduction of UCTs that can be performed unnecessarily in patients with UTI pre-diagnosis
Objective: Urine culture test (UCT), which is the gold-standard for urinary tract infections (UTI), requires higher cost, labour and time than complete urinalysis (CU). Therefore, it is important to assess prediction performance of CU's for UCT. the aim of our study is to demonstrate performance of strip leukocyte, erythrocyte, nitrite, microscopic leukocyte and microscopic erythrocyte tests in relation with UCT. Material and Methods: Patients which had CU, UCT requests and UTI pre-diagnosis in Kemalpasa State Hospital Central Laboratory during 6 months’ period were included. Performance of strip leukocyte, erythrocyte, nitrite, microscopic leukocyte and erythrocyte tests was evaluated with reference to UCT. Sensitivity, specificity, PV+, PV-, LR+ and LR- values were calculated. Relationship between assessed tests and UCT was analysed by logistic-regression. Results: of 606 samples with CU and UCT request on the same day, UCT positivity was not detected in 513 (84,6%). Sensitivity was highest for strip leukocyte (trace) (93,5%), and lowest for strip erythrocyte (3+) (25,8%), and specificity was highest for nitrite (98,2%) and lowest for strip leukocyte (trace) (51,2%). Highest PV+ was in nitrite (86,4%) and highest PV- was in microscopic leukocyte (97,4%) and strip leukocyte (trace) (97,8%) tests. LR+ was calculated as 34,9 for nitrite and <10 for others. Smallest LR- values for microscopic leukocyte and strip leukocyte (trace) tests were found to be 0,15 and 0,13 respectively. in nitrite positivity, risk of significant growth in UCT increased by 45 times. Conclusion: We conclude that combined evaluation of nitrite and strip leukocyte tests in CU before UCT request may contribute to the reduction of UCTs that can be performed unnecessarily in patients with UTI pre-diagnosis
Açıklama
Anahtar Kelimeler
Biyokimya ve Moleküler Biyoloji
Kaynak
Türk Klinik Biyokimya Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
15
Sayı
2
