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首页> 外文期刊>Journal of Clinical Microbiology >Reassessment of Routine Midstream Culture in Diagnosis of Urinary Tract Infection
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Reassessment of Routine Midstream Culture in Diagnosis of Urinary Tract Infection

机译：常规中游培养在尿路感染诊断中的重新评估

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Midstream urine (MSU) culture remains the gold standard diagnostic test for confirming urinary tract infection (UTI). We previously showed that patients with chronic lower urinary tract symptoms (LUTS) below the diagnostic cutoff on MSU culture may still harbor bacterial infection and that their antibiotic treatment was associated with symptom resolution. ABSTRACT Midstream urine (MSU) culture remains the gold standard diagnostic test for confirming urinary tract infection (UTI). We previously showed that patients with chronic lower urinary tract symptoms (LUTS) below the diagnostic cutoff on MSU culture may still harbor bacterial infection and that their antibiotic treatment was associated with symptom resolution. Here, we evaluated the results of the United Kingdom’s MSU culture in symptomatic patients and controls. Next, we compared the bacterial enrichment capabilities of the MSU culture with those of a 50-μl uncentrifuged culture, a 30-ml centrifuged sediment culture, and 16S rRNA gene sequencing. This study was conducted on urine specimens from 33 LUTS patients attending their first clinical appointment (mean age, 48.7?years; standard deviation [SD], 16.5?years), 30 LUTS patients on treatment (mean age, 47.8?years; SD, 16.5?years) whose symptoms had relapsed, and 29 asymptomatic controls (mean age, 40.7?years, SD, 15.7?years). We showed that the routine MSU culture, adopting the UK interpretation criteria tailored to acute UTI, failed to detect a variety of bacterial species, including recognized uropathogens. Moreover, the diagnostic MSU culture was unable to discriminate between patients and controls. In contrast, genomic analysis of urine enriched by centrifugation discriminated between the groups, generating a more accurate understanding of species richness. In conclusion, the United Kingdom’s MSU protocol misses a significant proportion of bacteria, which include recognized uropathogens, and may be unsuitable for excluding UTI in patients with LUTS.
机译：中游尿（MSU）培养仍然是确认尿路感染（UTI）的金标准诊断测试。我们以前曾证明，患有慢性下尿路症状（LUTS）低于MSU培养物诊断界限的患者可能仍带有细菌感染，其抗生素治疗与症状缓解相关。摘要中游尿液（MSU）培养仍然是确认尿路感染（UTI）的金标准诊断测试。我们以前曾证明，患有慢性下尿路症状（LUTS）低于MSU培养物诊断界限的患者仍可能感染细菌，他们的抗生素治疗与症状缓解相关。在这里，我们评估了有症状患者和对照者英国MSU文化的结果。接下来，我们将MSU培养物与50μl非离心培养物，30 ml离心沉淀物培养物和16S rRNA基因测序的细菌富集能力进行了比较。这项研究是针对33位接受首次临床约会的LUTS患者（平均年龄48.7岁;标准差[SD]为16.5岁），30位接受治疗的LUTS患者（平均年龄47.8岁; SD，症状已复发的患者为16.5岁，无症状对照者为29位（平均年龄为40.7岁，标准差为15.7岁）。我们发现，常规的MSU培养采用了针对急性UTI的英国解释标准，未能检测到各种细菌，包括公认的尿毒症。而且，MSU诊断文化无法区分患者和对照。相比之下，通过离心富集的尿液的基因组分析可区分各组，从而对物种丰富度有了更准确的了解。总之，英国的MSU协议遗漏了大量细菌，其中包括公认的尿路致病菌，可能不适合将LUTS患者排除在外。

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