DETECTION OF PYURIA AND BACTERIURIA IN SYMPTOMATIC AMBULATORY WOMEN

被引:26
作者
BLUM, RN [1 ]
WRIGHT, RA [1 ]
机构
[1] DENVER DEPT HLTH & HOSP,DIV PUBL & COMMUNITY HLTH SERV,605 BANNOCK ST,DENVER,CO 80204
关键词
DIPSTICK URINALYSIS; PREDICTION; URINARY TRACT INFECTION; PYURIA; BACTERIURIA; AMBULATORY CARE; WOMEN;
D O I
10.1007/BF02598002
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective: To compare the abilities of two methods for rapid detection of pyuria and three methods of urinalysis to predict significant bacteriuria in symptomatic ambulatory women. Design: Prospective simultaneous comparison of the results of dipstick urinalysis, standard microscopic urinalysis, and hemocytometric cell counting and Gram staining with the results of a standard urine culture. Setting: Two outpatient ambulatory care facilities serving predominantly minority and uninsured individuals. Selection criteria: Nonpregnant women presenting with symptoms of urinary tract infection without symptoms of vaginal infection. Measurements and main results: 105 women with symptoms were evaluated. The sensitivities of the dipstick urinalysis and the microscopic urinalysis in predicting pyuria as defined by hemocytometry were 0.76 and 0.77, respectively, and their specificities were 0.94 and 0.97, respectively. The sensitivities and specificities of the three methods of urinalysis in predicting greater-than-or-equal-to 10(4) colony-forming units (CFU)/mm3 in a urine culture were 0.88 and 0.70 for the leukocyte esterase-nitrite dipstick urinalysis, 0.98 and 0.68 for the standard microscopic urinalysis, and 1.00 and 0.49 for the Gram staining and hemocytometric cell counting. Conclusions: The standard urinalysis was the most accurate single method to predict significant bacteriuria in symptomatic ambulatory women. Sequencing the dipstick urinalysis with the standard urinalysis may be a cost-effective approach to evaluating these patients in clinical practice.
引用
收藏
页码:140 / 144
页数:5
相关论文
共 26 条
[1]  
Koch H.K., The National Ambulatory Medical Care Survey, Department of Health, Education, and Welfare, (1978)
[2]  
Komaroff A.L., Acute dysuria in women, N Engl J Med, 310, pp. 368-75, (1984)
[3]  
Stamm W.E., Counts G.W., Running K.R., Fihn S., Turck M., Holmes K.K., Diagnosis of coliform infection in acutely dysuric women, N Engl J Med, 307, pp. 463-8, (1982)
[4]  
Stamm W.E., Wagner K.F., Ael R., Et al., Causes of the acute urethral syndrome in women, N Engl J Med, 303, pp. 409-15, (1980)
[5]  
Stamm W.E., Measurement of pyuria and its relation to bacteriuria, Am J Med, 75, pp. 53-8, (1983)
[6]  
Mabeck C.E., Studies in urinary tract infections IV. Urinary leukocyte excretion in bacteriuria, Acta Med Scand, 186, pp. 193-8, (1969)
[7]  
Stansfield J.M., The measurement and meaning of pyuria, Arch Dis Child, 37, pp. 257-62, (1982)
[8]  
Little P.J., A comparison of the urinary white cell concentration with the white cell excretion rate, Br J Urol, 36, pp. 360-3, (1964)
[9]  
Schumann G.B., Schweitzer S.C., Examination of urine, Clinical diagnosis and management by laboratory methods, (1991)
[10]  
Alwall N., Pyuria: deposit in high-power microscopic field WBC/hpf versus WBC/mL in counting chamber, Acta Med Scand, 194, pp. 537-40, (1973)