尿培养标本不合格率及影响因素分析  

An Analysis of Unqualified Rate and Influencing Factors of Urine Culture

作　　者：唐圣闻 张曼 TANG Shengwen;ZHANG Man(Department of Clinical Laboratory,Beijing Shijitan Hospital,Capital Medical University,Department of Clinical Laboratory,Peking University Ninth School of Clinical Medicine,Beijing Key Laboratory of Urinary Cellular and Molecular Diagnostics,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院医学检验科,北京大学第九临床医学院医学检验科,尿液细胞分子诊断北京市重点实验室,北京100038

出　　处：《标记免疫分析与临床》2020年第10期1785-1788,1819,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的在我国,尿路感染(urinary tract infection,UTI)是临床常见的感染性疾病之一,合理控制影响尿培养标本不合格率的因素对尿路感染的临床诊断及治疗有重大意义,现回顾性分析本院尿培养送检标本的不合格率及其影响因素,为临床提供参考。方法对本院2019年临床各科室送检的6544份尿培养标本的不合格率进行统计处理,并对不合格标本进行原因分析。结果6544例尿培养标本中,共发现892例不合格标本,不合格率为13.63%,不合格率较高的科室为患者多伴神经功能障碍的神经内科(28.90%)、患者免疫功能低下的肿瘤内科(21.28%)和以糖代谢紊乱患者为主的内分泌科(20.19%),不合格率较低的科室为普外科(8.28%)、泌尿外科(9.38%)和心内科(9.52%);女性患者尿培养标本不合格率显著高于男性(14.91%vs 12.66%,P<0.05),同时尿培养标本不合格率随年龄增长显著升高(P<0.05)。影响因素的单因素分析显示,超时送检的尿培养标本不合格率显著高于2 h内送检的尿培养标本(15.92%vs 13.19%,P<0.05),经导管留取的尿培养标本不合格率显著高于清洁中段尿和膀胱穿刺获得的尿培养标本(15.37%vs 8.87%vs 0.00%,P<0.05)。结论神经系统病变患者、免疫力低下的患者及糖代谢功能紊乱的患者留取合格尿培养标本的难度较大;老年患者及女性患者的尿培养标本不合格率较高;导管尿和清洁中段尿不是理想的尿培养标本来源,膀胱穿刺尿标本质量较高,比较符合尿培养标本的检验标准;送检超时对尿培养标本不合格率的影响很大。Objective Urinary tract infection(UTI)in China is one of the most common bacterial infections.Appropriately managing the factors affecting the unqualified rate of urine culture contributes significantly to the generation of meaningful urine culture results that ultimately affects patient diagnosis and treatment.The purposes of this review is to identify and evaluate influencing factors associated with urine culture specimens and to assess their impacts on the unqualified rate of urine culture.Methods 6544 urine culture specimens were collected in Beijing Shijitan Hospital affiliated to Capital Medical University from January,2019 to December,2019.The unqualified specimens were sorted by the type of influencing factors and then analyzed.Results The total unqualified rate of urine culture was about 13.63%(892/6544).Among all of the departments,neurology has the highest unqualified rate(28.90%),followed by oncology(21.28%)and endocrinology(20.19%).The patients in these departments had always accompanied with neurological deficits,lower immunity and abnormal glucose metabolism.The unqualified rate of surgery was the lowest(8.28%),followed by urology(9.38%)and cardiology(9.52%).The unqualified rate was significantly higher in the female specimens than the male specimens(14.91%vs 12.66%,P<0.05)and both of them increased with age(P<0.05).Meanwhile,it was significantly higher in overtime specimens than the normal specimens(15.92%vs 13.19%,P<0.05).The catheterized urine specimens had a higher unqualified rate than midstream urine specimens and suprapubic aspiration urine specimens(15.37%vs 8.87%vs 0.00%,P<0.05).Conclusion Patients with neurological deficits,lower immunity and abnormal glucose metabolism are hard to provide qualified urine culture specimens.Unqualified rates for the female and the old patients are significantly higher than other types of patients.The suprapubic aspiration urine is high-quality urine culture specimens,while catheterized urine and midstream urine are not recommended for urine culture.The tur

关 键 词：尿液培养 不合格样本 不合格率 

分 类 号：R446.1[医药卫生—诊断学]