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KMID : 1100820210110030155
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Laboratory Medicine Online
2021 Volume.11 No. 3 p.155 ~ p.161
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A Study for Accurate Reporting of Bacteria in Urine by Manual Microscopic Examination
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Jeon You-La
Lee Woo-In
Kang So-Young
Kim Myeong-Hee
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Abstract
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Background: Since there is no standardized criterion for the semi quantitation of bacteria in manual microscopic examination, activities for reducing the subjectiveness of manual microscopic examination for detecting urinary bacteria are required.
Methods: This study was performed on specimens with result of WBC 0-1/a few bacteria in an automated urine sediment analyzer (Roche Diagnostic International, Switzerland). To establish the criterion for semi quantitation of bacterial counting, 43 specimens were examined by five technologists using manual microscopy and compared with the results of Gram staining. After application of the criterion, 71 specimens were examined by manual microscopy, following which, Gram staining and a urine culture were also performed.
Results: The newly established criterion was as follows: negative (<20/high-power field, HPF), a few (20-30/HPF), moderate (31-49/HPF), and many (≥50/HPF). The analytical sensitivity of the instrument was adjusted (from 18.18/field to 30/field) to decrease false positivity. After establishment of the criterion and education, the agreement rate was increased from 52.8% to 95.8%, and the specificity increased from 32.5% to 87.7% with the same sensitivity.
Conclusions: It will be necessary to ensure that all technologists apply the same criterion in the laboratory and clinical settings, assess the analytical sensitivity of an automated analyzer, and educate on the correct interpretation of urine microscopic examination.
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KEYWORD
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Urine sediment, Bacteria, Microscopic examination
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