運用聚集帶分布方法在雷射細胞流速儀上來辨別桿菌及球菌/雜菌:與傳統UF1000i方法的比較
楊淳淳1 黃蕙菁1 張尚仁2,3 楊緒棣2,3
台北慈濟醫院佛教慈濟基金會 1檢驗科 2外科部泌尿科；3慈濟大學醫學院泌尿科
Cluster Band method in laser flow cytometry analysis of rod or cocci/mix growth bacteria: comparisons with classical UF1000i method
Chun-Chun Yang 1; Hui-Ching Huang 1; Shang-Jen Chang2,3; Stephen Shei-Dei Yang2;3
1Department of Laboratory Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation;
2Division of Urology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan
3Medical College of Buddhist, Tzu Chi University, Hualien, Taiwan

Purpose:
Using UF1000i (Sysmex, Kobe, Japan), we were able to predict growth of rod or cocci/mixed growth before urine culture (J Clin Lab Anal 2017 Sep; 31(5)). This study, we aimed to increase sensitivity rate of UF1000i in the differentiation of rods, cocci/mixed bacteria from women with uncomplicated urinary tract infection (uUTI).  

Methods:
From January 2017 to January 2018, we enrolled 74 adult women (≧18 years old) with uUTIs from urologic clinics for study. Urine analyses were performed with laser flow cytometry and then diagrams were generated (forward scatter vs. fluorescent light scatter). Each specimen was classified as either rods or cocci/mixed growth according to the diagrams. Standard urine cultures were performed. The bacterial diagram has 5 units in the x-axis and in the y-axis.
According to the original description of UF1000i, if the angles of the clustered dots are ≦30。or >30。, the predicted culture results are rod or cocci/ mixed bacteria (classical method). We defined Cluster Band (CB) method in 3 ways: angle, width, and length, and interpret results as the followings. If the angles are <30。(mostly are 10。~20。), width <1 unit (mostly 1/3 to 1 units), and length between 1.5 to 4 units, the predicted results of urine culture are rods. If the width of the band clusters are greater than 1 unit in y-axis, the predicted results of culture are cocci/mixed bacteria. 

Results:
Based on the results of urine culture, the CB method had a 91% sensitivity rate (49 out of 54) in predicting rods and a 65% sensitivity rate (13 out of 20) in predicting cocci/mixed growth. However, the classical UF-1000i method had a 76% sensitivity rate in predicting rods (41 out of 54) and a 50% (10 out of 20) sensitivity rate in predicting cocci/mixed growth.

Conclusions:
Through the Cluster Band method, we were able to increase the prediction of rods or cocci/mixed growth of bacteria before urine culture. Large scale studies are required to prove its applicability and clinical usefulness in the future.