尿液菌落计数在儿童泌尿感染筛查中的应用  

Application of urine culture colony counts in screening of urinary tract infections in children

作　　者：郭玺[1] 段燚星[1] 祖雄兵[2] GUO Xi;DUAN Yixing;ZU Xiongbing(Hu＇nan Provincial People＇s Hospital,Changsha,Hu＇nan 410005,China)

机构地区：[1]湖南省人民医院泌尿外科,湖南长沙410002 [2]中南大学湘雅医院泌尿外科,湖南长沙410000

出　　处：《中国微生态学杂志》2018年第7期825-827,共3页Chinese Journal of Microecology

基　　金：湖南省卫生计生委科研计划课题项目(B2016016)

摘　　要：目的检验和比较尿液菌落计数在筛选儿童泌尿系统感染中的可靠性。方法收集儿童中段尿液,10μL进行细菌培养和菌落计数,剩余样本进行干化学分析,主要进行沉渣镜检、亚硝酸盐和白细胞酯酶检测。结果共检测中段尿液标本112份,其中32例培养出有意义细菌,阳性率为28.6%。尿沉渣镜检、干化学分析的敏感性分别为68.8%和78.1%,特异性分别为92.5%、90.0%。另有7例培养阳性,干化学分析阴性,假阴性为21.9%;6例沉渣镜检阳性,培养阴性,假阳性率7.5%;沉渣镜检、干化学分析的阳性预示值分别为78.6%和75.8%。结论尿液细菌培养和菌落计数在筛选儿童泌尿感染的敏感性要明显优于尿沉渣镜检和干化学分析,在儿童泌尿系统感染筛查中起到重要作用。尿沉渣镜检和干化学分析因为敏感性不足、结果易受到感染类型影响。尿液菌落计数可作为儿童泌尿系统感染检测的重要指标。Objective To verify and compare the reliability of urine culture colony counts in the screening of urinary tract infections in children.Methods The samples of midstream urine of children were collected for bacterial culture and colony counts,as well as for dry chemical analysis including microscopic examination of sediment and detection of nitrites and leukocyte esterase.Results A total of 112 urine specimens were detected,32 of which（28.6%）presented significant results.The sensitivity of microscopic examination and dry chemical analysis of urinary sediment was 68.8% and 78.1% respectively,while the specificity was92.5% and 90.0% respectively.7 cases positive by culturing but negative by dry chemical analysis,indicating a false negative rate of 21.9%.6 samples of sediments were positive by microscopic examination but negative by culturing,with the false positive rate being 7.5%.The positive predictive values of sediment microscopic examination and dry chemical analysis were 78.6% and 75.8%respectively.Conclusion Bacterial culture and colony counts of urine are significantly more sensitive than urine sediment microscopy and dry chemical analysis for screening urinary tract infections in children,as the latter two methods are susceptible to the infection types due to insufficient sensitivity.Urine culture colony counts can be used as an important indicator for the detection of urinary tract infections in children.

关 键 词：儿童 泌尿感染 尿液菌落计数 

分 类 号：R691.3[医药卫生—泌尿科学]