İbrahim KAPLAN, Gülten TOPRAK, Osman EVLİYAOĞLU, Hatice YÜKSEL, Seyit KUŞ, Tuba DAL

İdrar kültürü testi gerekliliğini öngörmede tam otomatik idrar analizi sonuçlarının performansı

Amaç: Tam idrar analizi ve idrar kültürü idrar yolu enfeksiyonlarının tanısı için sıklıkla yapılan incelemelerdendir. Çalışmamızın amacı tam idrar analizinin tanısal performansını ve idrar kültürü gerekliliğini belirlemedeki rolünü incelemektir.Yöntemler: İdrar kültürü ve tam idrar analizi sonucu olan 362 hasta sonucu retrospektif olarak incelendi. Kültür sonuçları referans kabul edilerek, idrarın kimyasal ve mikroskopik incelemesinde, idrar yolu enfeksiyonu göstergesi olabilecek testlerin tanısal doğruluk parametreleri hesaplandı ve kültür istemini öngörmedeki performansı değerlendirildi.Bulgular: Toplam 362 hastaya ait idrar kültürü sonuçlarının %67 si negatifti ve bu kültür sonucu negatif olan örneklerin %50,4 ünde kimyasal analizde lökosit esteraz, nitrit ve mikroskopik analizde lökosit ve bakteri sonuçları normal olarak bulundu. Tanısal doğruluk hesaplamalarında, lökosit esteraz (%86,1) ve mikroskopide lökosit (%88,0) testlerinin sensitiviteleri yüksek bulunurken, nitrit (%95,4) ve bakteri (%86,6) incelemelerinin spesifiteleri yüksek bulundu. Mikroskopide lökosit incelemesi için yapılan ROC analizinde eğri altındaki alan 0,852 olarak hesaplandı. Sonuç: Tam otomatik idrar cihazları, tam idrar analizi için yeterli tanısal doğruluğu sağlayabilmektedir. Tam idrar analizi sonuçlarının etkin bir şeklide değerlendirilmesi kültür istemleri için gerekliliği öngörebilir ve laboratuvarlarda özellikle iş yükü ve maliyetin azalmasına katkı sağlayabilir.

The performance of fully automated urine analysis results for predicting the need of urine culture test

Objective: Urinalysis and urine culture are most common tests for diagnosis of urinary tract infections. The aim of our study is to examine the diagnostic performance of urine analysis and the role of urine analysis to determine the requirements for urine culture.Methods: Urine culture and urine analysis results of 362 patients were retrospectively analyzed. Culture results were taken as a reference for chemical and microscopic examination of urine and diagnostic accuracy of the test parameters, that may be a marker for urinary tract infection, and the performance of urine analysis were calculated for predicting the urine culture requirements.Results: A total of 362 urine culture results of patients were evaluated and 67% of them were negative. The results of leukocyte esterase and nitrite in chemical analysis and leukocytes and bacteria in microscopic analysis were normal in 50.4% of culture negative urines. In diagnostic accuracy calculations, leukocyte esterase (86.1%) and microscopy leukocytes (88.0%) were found with high sensitivity, nitrite (95.4%) and bacteria (86.6%) were found with high specificity. The area under the curve was calculated as 0.852 in ROC analysis for microscopic examination for leukocytes.Conclusion: Full-automatic urine devices can provide sufficient diagnostic accuracy for urine analysis. The evaluation of urine analysis results in an effective way can predict the necessity for urine culture requests and especially may contribute to a reduction in the work load and cost.

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