Utility of dipstick urinalysis in peri- and postmenopausal women with irritative bladder symptoms
Utility of dipstick urinalysis in peri- and postmenopausal women with irritative bladder symptoms
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DOI：
10.1007/s00192-013-2247-z
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发表时间：
2014-04-01
影响因子：
1.8
通讯作者：
Lowder, Jerry L.
中科院分区：
文献类型：
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作者：
Turner, Lindsay C.;Beigi, Richard;Lowder, Jerry L.
先前对无症状围绝经期和绝经后妇女进行尿路试纸分析（UA）的研究表明，检测尿路感染（UTI）的敏感性较差。我们假设在有症状的围绝经期和绝经后妇女中，该试验的敏感性会得到改善。这是一项对76名因膀胱刺激性症状寻求泌尿妇科护理的女性进行的横断面研究。白细胞酯酶（LE）或亚硝酸盐（NIT）清洁捕获（CC）试纸UA阳性的受试者被纳入。在CC和导管标本上进行试纸UA，然后进行微生物培养。计算CC和导管UA的试验特征。采用Spearman相关系数对CC培养与导管培养（金标准）进行比较。75/76（98.7%）入组受试者可获得数据进行分析。平均年龄68±11岁。大多数受试者为绝经后（98.7%）和白种人（97.3%）。在CC和导管标本中，量尺的灵敏度分别为48%至87%和35%至57%。在该人群中，来自NIT阳性CC标本的试尺UA具有最高的灵敏度（60.9）、特异性（100）、阴性预测值（85.2）和阳性预测值（100）。CC和导管标本的量尺UA检测uti的灵敏度相似。当10(3)个菌落形成单位的培养结果被认为是阳性时，CC和导管标本的相关性中等（rho = 0.470）。与先前发表的CC和导管取样结果相比，本研究中试纸UA的灵敏度都有所提高。在获得尿培养结果之前，对有刺激性膀胱症状和nni阳性CC试纸UA的妇女开始经验性抗生素治疗是一个合理的选择。
Previous studies of dipstick urinalysis (UA) in asymptomatic peri- and postmenopausal women demonstrate poor sensitivity to detect a urinary tract infection (UTI). We hypothesized that sensitivity of this test would be improved in symptomatic peri- and postmenopausal women.This was a cross-sectional study of 76 women seeking urogynecology care for irritative bladder symptoms. Subjects with a positive clean-catch (CC) dipstick UA for leukocyte esterase (LE) or nitrites (NIT) were offered enrollment. Dipstick UA was performed on CC and catheterized specimens, followed by microbiologic culture. Test characteristics were calculated for CC and catheterized UA. CC culture was compared with catheterized culture (gold standard) using Spearman's correlation coefficient.Data was available for analysis in 75/76 (98.7 %) enrolled subjects. Mean age was 68 +/- 11 years. Most subjects were postmenopausal (98.7 %) and Caucasian (97.3 %). Dipstick sensitivity ranged from 48 % to 87 % and 35 % to 57 % in CC and catheterized specimens, respectively. Dipstick UA from a CC specimen positive for NIT had the highest sensitivity (60.9), specificity (100), negative predictive value (85.2), and positive predictive value (100) in this population. Dipstick UA from CC and catheterized specimens had similar sensitivity for detecting UTIs. When culture results of 10(3) colony-forming units were considered positive, CC and catheterized specimens were moderately correlated (rho = 0.470).Dipstick UA in this study had improved sensitivity compared with previously published results in both CC and catheterized samples. Initiation of empiric antibiotic treatment in women with irritative bladder symptoms and NIT-positive CC dipstick UA prior to obtaining urine culture results is a reasonable option.