Annals of Clinical Microbiology

The Korean Society of Clinical Microbiology (대한임상미생물학회)
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Selection of Unnecessary Urine Culture Specimens Using Sysmex UF-5000 Urine Flow Cytometer

Sysmex UF-5000 소변 유세포분석기를 이용한 요배양 불필요 검체의 선별

  • Song, Duyeal (Department of Laboratory Medicine, Pusan National University School of Medicine) ;
  • Lee, Hyun-Ji (Department of Laboratory Medicine, Pusan National University School of Medicine) ;
  • Jo, Su Yeon (Department of Laboratory Medicine, Pusan National University School of Medicine) ;
  • Lee, Sun Min (Department of Laboratory Medicine, Pusan National University School of Medicine) ;
  • Chang, Chulhun L. (Department of Laboratory Medicine, Pusan National University School of Medicine)
  • 송두열 (부산대학교 의과대학 진단검사의학교실) ;
  • 이현지 (부산대학교 의과대학 진단검사의학교실) ;
  • 조수연 (부산대학교 의과대학 진단검사의학교실) ;
  • 이선민 (부산대학교 의과대학 진단검사의학교실) ;
  • 장철훈 (부산대학교 의과대학 진단검사의학교실)
  • Received : 2018.03.08
  • Accepted : 2018.06.22
  • Published : 2018.12.20
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Abstract

Background: Urine culture is one of the most frequently requested tests in microbiology. Automated urine analyzers yield much infection-related information. The Sysmex UF-5000 analyzer (Sysmex, Japan) is a new flow cytometry urine analyzer capable of quantifying urinary particles, including bacteria, WBCs, and yeast-like cells (YLCs) and can provide a Gram stainability flag. In this work, we evaluated how many unnecessary urine cultures could be screened out using the UF-5000. Methods: We compared the culture results of 126 urine samples among 453 requested urine cultures (from sources other than the Urology and Nephrology departments) with urinalysis results. Urine cultures were considered positive if bacterial or YLC growth was ${\geq}10^4CFUs/mL$. Results: We used urinalysis cut-off values of $50/{\mu}L$ and $100/{\mu}L$ for bacteria and YLC, respectively. Forty eight of the 126 (38.1%, or 10.6% of 453 requested) cultures were below these cut-off values and did not contain any culture-positive samples. Conclusion: Bacteria and YLC counts generated using the UF-5000 analyzer could be used to screen out negative cultures and reduce urine culture volume by ~10% without sacrificing detection of positive cultures.

배경: 요배양검사는 요로감염 진단을 위한 표준검사로 가장 흔히 의뢰되는 미생물 배양 검사 중 하나이다. 소변 자동분석기는 감염과 관련된 많은 정보를 제공한다. 최근 개발된 Sysmex UF-5000 (Sysmex, Japan)은 유세포분석 방법에 의해 세균, 효모균, 백혈구 등의 입자를 정량적으로 측정하고, 그람 염색성 정보를 제공한다. 저자들은 UF-5000을 이용하여 불필요한 요배양검사를 얼마나 선별할 수 있는지 평가하였다. 방법: 요배양검사가 의뢰된 453 검체 중 비뇨기과/신장내과 의뢰 검체를 제외한 126 검체를 대상으로 요시험지봉검사와 UF-5000으로 검사를 시행하여 요배양검사 결과와 비교하였다. 소변 배양은 집락수가 $10^4CFU/mL$ 이상인 경우 양성으로 판정하였다. 결과: UF-5000의 세균 수 $50/{\mu}L$이하, 효모양 세포 $100/{\mu}L$ 이하를 기준으로 했을 때 분석 대상 요배양의 38.1% (48/126), 전체 요배양 453건의 10.6%를 불필요한 요배양검사로 선별해 낼 수 있었다. 결론: UF-5000에서 산출된 세균 및 효모양 세포의 수로 음성 배양 결과를 예측할 수 있으며 약 10%의 불필요한 배양검사를 줄일 수 있다.

Keywords

Acknowledgement

Supported by : Pusan National University Yangsan Hospital

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