Üriner Sistem Enfeksiyonlarının Erken Saptanmasında Hızlı Tanı Testlerinin Değeri

Üriner sistem enfeksiyonları (ÜSİ) tüm bakteriyel enfeksiyonların en sık nedenidir; sunulan bu çalışmanın amacı üriner sistem enfeksiyonlarının erken saptanmasında hızlı tanı testlerinin değerinin belirlenmesidir. ÜSİ olan 128 hasta ve kontrol grubu olarak 128 sağlıklı kişi çalışmaya dahil edildi. Hastalardan elde edilen idrar örnekleri Gram boyama, mikroskopik piyüri, dipstik (nitrit ve lökosit esteraz) ve kantitatif idrar kültürü ile olası ÜSİ yönünden değerlendirildi. Tüm tarama testlerinin duyarlılığı, özgüllüğü, pozitif (PPV) ve negatif kestirim değerleri (NPV) altın standart olarak idrar kültürleri kullanılarak belirlendi ve karşılaştırmalar yapıldı. Bu dört tarama metodu için duyarlılık, özgüllük, PPV ve NPV değerleri idrar kültür sonuçlarına (referans yöntem) göre hesaplandı. Sonuç olarak, Gram boyama diğer hızlı tanı yöntemleri ile karşılaştırıldığında daha değerli bulundu

The Validity of the Rapidly Diagnostic Tests for Early Detection of Urinary Tract Infection

Urinary tract infectious (UTI) is the most common of all bacterial infections; the purpose of the present study was to determine the validity of rapidly diagnostic tests for the early detection of UTIs in patients. 128 patients who had UTIs and control group consisted of 128 subjects who had not UTIs were included to the study. Urine specimens obtained from the patients were evaluated for possible UTI by Gram staining, microscopic pyuria, dipstick (nitrite and leukocyte esterase), and quantitative urine culture. Using the quantitative urine culture as the gold standard (reference test), the sensitivity, specificity, and positive (PPV) and negative predictive values (NPV) of all the screening tests were determined and compared. The sensitivity, specificity, PPV, and NPV for the four screening methods were calculated against the urine culture (reference method) for the diagnosis of UTI. In conclusion, validity of Gram stain was found higher compared to other rapid diagnostic tests

___

  • Zorc J.J., Kiddoo D.A., Shaw K.N. Diagnosis and Management of Pediatric Urinary Tract Infections. Clinical Microbiology Reviews, Apr., p. 417–422, 2005.
  • Kass, E.H. Asymptomatic infections of the urinary tract. Trans. Assoc. Am. Physicians; 69:56–64, 1956.
  • Hellerstein S. Recurrent UTI in children. Pediatr Infect Dis J. 1: 271–281, 1992.
  • Hurlbut T.A., Littenberg B, and the Diagnostic Technology Assessment Consortium. The diagnostic accuracy of rapid dipstick tests to predict urinary tract infection. Am J Clin Pathol. 96:582–588, 1991.
  • Lohr J.A. Use of routine urinalysis in making a presumptive diagnosis of urinary tract infection in children. Pediatr Infect Dis J. 10:646–650, 1991.
  • Todd J.K. Diagnosis of urinary tract infections. Pediatr Infect Dis J.1:126–131, 1982.
  • Hoberman A., Wald E.R., Penchansky L., Reynolds E.A., Young S. Enhanced urinalysis as a screening test for urinary tract infection. Pediatrics. 91:1196–1199, 1993.
  • Hoberman A, Wald E.R., Reynolds E.A., Penchansky L., Charron M. Is urine culture necessary to rule out urinary tract infection in young febrile children? Pediatr Infect Dis J. 15:304–309, 1996.
  • Lockhart G.R., Lewander W.J., Cimini D., et al. Use of urinary Gram stain for detection of urinary tract infection in infants. Ann Emerg Med. 25:31–35, 1995.
  • Oreson R., Groschel D.H.M. Leucocyte esterase activity and nitrite test as a rapid screen for significant bacteriuria. J Clin Microbiol 21:840-842, 1985.
  • Deville W., Yzermans J.C., Duijn N.P., Bezemer P.D., Windt D. and Bouter L.M. The urine dipstick test useful to rule out infections. A meta-analysis of the accuracy. BMC Urology4:4.2004URLhttp://www.biomedcentr al.com/1471-2490/4/4.
  • Shaw K.N., McGowan K.L., Gorelick M.H., Schwartz J.S. Screening for urinary tract infection in infants in the emergency department: which test is best? Pediatrics 101, 1998.URL:http://www.pediatrics.org/cgi/conte nt/full/101/6/e1
  • Shaw K.N., Hexter D., McGowan K.L., Schwartz J.S. Clinical evaluation of a rapid screening test for urinary tract infections in children. J Pediatr. 118:733-736, 1991.