İdrar örneklerinin değerlendirilmesinde yeni bir skorlama yöntemi
Yükleniyor...
Tarih
2011
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Üriner sistem infeksiyonlarında (ÜSİ) kültür yapmadan önce yol gösterici olabilecek bir skorlama yöntemi bulunması amaçlanmıştır. Yöntemler: Laboratuvarımıza gönderilen 550 hastadan alınan idrar örnekleri standard kültür yöntemiyle ekildi. İdrarın mikroskopik incelenmesiyle pyüri ve bakteriüri değerlendirildi. Lökosit esteraz (LE) ve nitrit testi için Combur 10-Test® M 100 (Roche Diagnostics GmbH, Mannheim, Almanya) kullanıldı. İdrar örneklerini getiren hastaların semptomları sorgulandı. Bulgular: Olguların 68 (%12.4)’inde üreme oldu, 24 (%4.4)’ünde kontaminasyon saptandı ve 458 (%83.3)’inde üreme olmadı. Yaptığımız çalışmada beşli (semptom, Thoma lamı, Gram boyaması, LE, nitrit), dörtlü (semptom, Gram boyaması, LE, nitrit) ve üçlü (semptom, Gram boyaması, nitrit) parametreleri inceledik. Üçlü parametrede 2 ve üzeri puan alan toplam 38 hastanın hepsinde üreme oldu. Buna göre semptom, Gram boyaması ve nitritin en az ikisinin pozitif olduğu durumlarda skorlama yöntemimizin duyarlılığı %100’dü. Sonuçlar: Kültür, ÜSİ tanısında altın standard yöntem olmakla birlikte, idrar kültürü istenmeden önce ön tanı konulmasında ve ampirik tedavi başlanmasında bu üçlü parametre yol gösterici olabilir.
Objective: The aim of this study was to find a scoring method before carrying out a culture in patients with urinary system infections. Methods: The urine samples of 550 patients sent to our laboratory were cultured with standard methods. Pyuria and bacteriuria were evaluated with microscopic examination of the urine. Combur 10-Test® M 100 (Roche Diagnostics GmbH, Mannheim, Germany) was used for leucocyte esterase (LE) and nitrite tests. Symptoms of patients were recorded. Results: Bacterial growth in 68 (12.4%) and contamination in 24 (4.4%) cases was detected, while there was no growth in 458 (83.3%) cases. Groups of five (symptom, Thoma counting chamber, Gram stain, LE and nitrite), four (symptom, Gram stain, LE and nitrite) and three (symptom, Gram stain and nitrite) parameters were evaluated. Culture was positive in all 38 patients with 2 or more score points in the three-parameter group. Thus, sensitivity of the method was 100% when at least two parameters of symptom, Gram stain and nitrite were positive. Conclusions: Three parameters can be a guide for preliminary diagnosis and empirical therapy before urine culture, although the culture method is still the gold standard in diagnosing urinary system infection.
Objective: The aim of this study was to find a scoring method before carrying out a culture in patients with urinary system infections. Methods: The urine samples of 550 patients sent to our laboratory were cultured with standard methods. Pyuria and bacteriuria were evaluated with microscopic examination of the urine. Combur 10-Test® M 100 (Roche Diagnostics GmbH, Mannheim, Germany) was used for leucocyte esterase (LE) and nitrite tests. Symptoms of patients were recorded. Results: Bacterial growth in 68 (12.4%) and contamination in 24 (4.4%) cases was detected, while there was no growth in 458 (83.3%) cases. Groups of five (symptom, Thoma counting chamber, Gram stain, LE and nitrite), four (symptom, Gram stain, LE and nitrite) and three (symptom, Gram stain and nitrite) parameters were evaluated. Culture was positive in all 38 patients with 2 or more score points in the three-parameter group. Thus, sensitivity of the method was 100% when at least two parameters of symptom, Gram stain and nitrite were positive. Conclusions: Three parameters can be a guide for preliminary diagnosis and empirical therapy before urine culture, although the culture method is still the gold standard in diagnosing urinary system infection.
Açıklama
Anahtar Kelimeler
Enfeksiyon Hastalıkları, Mikrobiyoloji
Kaynak
Klimik Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
24
Sayı
2
Künye
Şahin E., Yürüken Z., Alanbayı Ü., Çınar T., Göçmen J. S. (2011). İdrar örneklerinin değerlendirilmesinde yeni bir skorlama yöntemi. Klimik Dergisi, 24(2), 86 - 89.
