南昌大学学报（医学版）
南昌大學學報（醫學版）
남창대학학보（의학판）
ACTA ACADEMIAE MEDICINAE JIANGXI
2014年
8期
59-61,65
,共4页
熊章华%陈益国%陈会%熊龙
熊章華%陳益國%陳會%熊龍
웅장화%진익국%진회%웅룡
尿培养%革兰染色%假阴性
尿培養%革蘭染色%假陰性
뇨배양%혁란염색%가음성
urine culture%Gram’s stain%false negative
目的：分析尿培养菌落计数不达标的原因，以提高尿细菌学检测的临床符合率。方法对73例尿培养菌落计数不达标住院患者的临床资料进行回顾性分析。结果73例尿培养菌落计数不达标患者中82．19％（60/73）有真性尿路感染。81．67％（49/60）的患者提前使用了抗生素，但抗生素提前使用的有效率仅为48．98％（24/49）。有临床尿路感染者尿沉渣涂片镜检有 WBC 所占比例显著高于尿沉渣涂片镜检无 WBC 的病例、尿培养阴性所占比例显著高于尿培养阳性（均 P ＜0．01）。尿培养＋尿沉渣涂片镜检阳性、阴性总符合率和误诊率均显著高于尿培养（均 P ＜0．01）。结论单纯尿定量培养不足以对提前使用抗生素患者进行尿路感染的实验室诊断，需要结合尿沉渣涂片以排除因抗生素误用或滥用导致的假阴性报告。
目的：分析尿培養菌落計數不達標的原因，以提高尿細菌學檢測的臨床符閤率。方法對73例尿培養菌落計數不達標住院患者的臨床資料進行迴顧性分析。結果73例尿培養菌落計數不達標患者中82．19％（60/73）有真性尿路感染。81．67％（49/60）的患者提前使用瞭抗生素，但抗生素提前使用的有效率僅為48．98％（24/49）。有臨床尿路感染者尿沉渣塗片鏡檢有 WBC 所佔比例顯著高于尿沉渣塗片鏡檢無 WBC 的病例、尿培養陰性所佔比例顯著高于尿培養暘性（均 P ＜0．01）。尿培養＋尿沉渣塗片鏡檢暘性、陰性總符閤率和誤診率均顯著高于尿培養（均 P ＜0．01）。結論單純尿定量培養不足以對提前使用抗生素患者進行尿路感染的實驗室診斷，需要結閤尿沉渣塗片以排除因抗生素誤用或濫用導緻的假陰性報告。
목적：분석뇨배양균락계수불체표적원인，이제고뇨세균학검측적림상부합솔。방법대73례뇨배양균락계수불체표주원환자적림상자료진행회고성분석。결과73례뇨배양균락계수불체표환자중82．19％（60/73）유진성뇨로감염。81．67％（49/60）적환자제전사용료항생소，단항생소제전사용적유효솔부위48．98％（24/49）。유림상뇨로감염자뇨침사도편경검유 WBC 소점비례현저고우뇨침사도편경검무 WBC 적병례、뇨배양음성소점비례현저고우뇨배양양성（균 P ＜0．01）。뇨배양＋뇨침사도편경검양성、음성총부합솔화오진솔균현저고우뇨배양（균 P ＜0．01）。결론단순뇨정량배양불족이대제전사용항생소환자진행뇨로감염적실험실진단，수요결합뇨침사도편이배제인항생소오용혹람용도치적가음성보고。
Objective To analyze the causes of substandard quantitative urine culture,and to improve the compliance rate of urinary bacteriological detection.Methods Clinical data of 73 pa-tients with substandard urine culture bacterial colony counts were analyzed retrospectively.Re-sults Among the 73 patients,60(82.19%)had true urinary tract infection.Among the 60 pa-tients,antibiotics were used in 49(81.67%).However,the effective rate of early use of antibiotics was only 48.98%(24/49).The microscopic examination of urine sediment showed that the per-centage of patients with the presence of white blood cells was significantly higher than that of pa-tients without the presence of white blood cells(P <0.01).In addition,the percentage of urine culture-negative patients was significantly higher than that of urine culture-positive patients(P <0.01).The overall compliance rate and misdiagnosis rate of the combination of urine culture and urine sediment microscopy were significantly higher than those of urine culture alone(P <0.01). Conclusion The quantitative urine culture alone is insufficient for the laboratory diagnosis of uri-nary tract infection in patients who receive antibiotics in advance.It must be combined with urine sediment microscopy to exclude the false negative reports resulted from antibiotic misuse or a-buse.
