泌尿道感染會影響UC3500白蛋白/肌酸酐自動分析儀的結果嗎?
黃蕙菁1 楊淳淳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
Does urinary tract infection affect the A/C ratio determination in automated urine analyzer, Sysmex UC-3500
Hui-Ching Huang 1; Chun-Chun Yang 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:
Microalbuminuria arises from increased leakage of small quantity albumin through the glomerular and is considered a predictor of progressive renal disease. However, the definition of microalbuminuria is affected by different sampling, detection and difference in albumin quantity range. Since proteinuria is a common finding with symptomatic UTI, we aimed to evaluate the performance of the automated urine analyzer, Sysmex UC-3500, for screening microalbuminuria in women with uncomplicated UTI.
Materials and Methods:
Subjects with uncomplicated cystitis defined as outpatient clinic patient, female, age from 20 to 70, and the score UTISA questionnaire >=4 were enrolled for study. The middle urine samples were collected after washing the vulva. Within one hour, the collected urine sample were analyzed by UC-3500 and UF-1000i (a laser flow cytometry detecting bacteria) and urine cultured. After antibiotic treatment the urine sample were collected again and analyzed by the same process. UC-3500 defined A/C ratios as negative, 1+, and 2+ if it is <30, 30~150 and ≥300 mg/gCr, respectively.
Results:
From Jan. 2017 to Jan. 2018, 74 women with uncomplicated cystitis were enrolled. Before treatment, the A/C ratios were 1+ to 2+ in 34 (45.9%) specimen, and negative in 40 (54.1%). After antibiotic treatment, 28 of 34 (82.4%) the initial A/C ratio positive (≥1+) turned to negative and 6 of 34 (17.6%) stayed positive. Thirty-eight of 40 (95%) the initially negative stayed negative and 2 (5%) turned to positive. Before treatment, 32 (55.2%) A/C ratio positives were observed in 58 LEU positive samples. After treatment, 30 (93.8%) A/C ratio positive turned to negative. Before treatment, 2 (12.5%) A/C ratio positives were detected in 16 LEU negative samples. These two cases remained A/C ratio positive after treatment. Before treatment, there are 30 A/C ratio positive (54.5%) in the 55 NIT positives and 4 A/C ratio positive (21.1%) in the 19 NIT negatives. After treatment, 28 A/C ratio positive (93.3%) turned to negative. The 4 NIT negative and A/C ratio positive cases turned to negative.
Conclusion: Microalbuminuria detected by UC-3500 may be affected by urinary tract infections. Both leukocyte esterase and nitrite may be linked to the detection of microalbuminuria by UC-3500.