UF5000检测酵母样真菌筛查真菌性尿路感染的应用评价

Evaluation of the application of UF5000 in screening fungal urinary tract infection by detecting yeast-like cells

目的:评估UF5000检测尿液中酵母样真菌(yeast-like cells,YLC)结果的准确性,并研究该参数能否用于筛查真菌性尿路感染。方法:选取318例疑似尿路感染患者的尿液标本,分别进行UF5000检测和细菌、真菌培养,显微镜镜检记录尿液中是否存在酵母菌。分别以镜下见到酵母菌和培养出真菌作为金标准,ROC曲线分析进行准确性评估。根据是否培养出真菌,以及真菌菌落生长的数量对尿液标本进行分组,非参数检验用于比较不同组间YLC水平的差异。结果:UF5000检测YLC真阳性的曲线下面积(Area under curve,AUC)为0.863,最佳cut off值2.80/μL。UF5000检测YLC预测真菌性尿路感染的AUC为0.913,最佳cutoff值8.95/μL。均有良好的敏感性(95.45%~97.37%)和阴性预测值(98.62%~98.73%)。组间比较显示真菌组YLC水平明显高于阴性组和细菌组(P值均为0.000),而真菌组内亚组仅≥105CFU/mL组YLC水平与105CFU/mL组差异有统计学意义(P=0.027)。结论:选取2.8/μL作为YLC的阳性标准,比厂家提供的6.0/μL更适用于本实验室的临床工作。选取8.95/μL作为最佳cutoff值时,UF5000检测的YLC结果可有效地筛查真菌性尿路感染。

Objective:To evaluate the accuracy of UF5000 in detecting yeast-like cells(YLC)in urine,and to study whether this parameter can be used to screen fungal urinary tract infection.Methods:Urine samples from 318 patients with suspected urinary tract infection were selected for UF5000 detection,bacterial and fungal culture,and microscopic examination was performed to record the presence of yeast in urine.The accuracy was evaluated by ROC curve analysis,with the yeast seen under the microscope and the fungus cultivated as the gold standard.Urine samples were grouped according to whether fungi were cultivated and the number of fungal colony growth.Non parametric test was used to compare the differences of YLC levels between different groups.Results:The area under curve(AUC)of true positive YLC detected by UF5000 is 0.863,and the best cut off value is 2.80/μL。TheAUC offungal urinary tractinfection predicted by YLC detected by UF5000 was 0.913,and the best cut offvalue was 8.95/μL。Bothhadgoodsensitivity(95.45%~97.37%)and negative predictive value(98.62%~98.73%).The comparison between the groups showed that the YLC level of the fungal group was significantly higher than that of the negative group and the bacterial group(P value was 0.000),while the YLC level of the subgroup only the YLC level of group>10^(5)CFU/mL was significantly different from that of group 105 CFU/mL(P=0.027).Conclusion:Select 2.8/μL as the positive standard of YLC,which is better than the 6.0/μL provided by the manufacturer is more suitable for clinical work in this laboratory.Select 8.95/μL as the best cut off value,the YLC result detected by UF5000 can effectively screen fungal urinary tract infection.