Urinalysis and Urinary Tract Infection: Update for Clinicians

[摘要] Dysuria is a common presenting complaint of women and urinalysis is a valuable tool in the initial evaluation of thispresentation. Clinicians need to be aware that pyuria is the best determinate of bacteriuria requiring therapy andthat values significant for infection differ depending on the method of analysis. A hemocytometer yields a value of≥ 10 WBC/ mm3significant for bacteriuria, while manual microscopy studies show ≥ 8 WBC/high-power fieldreliably predicts a positive urine culture. In cases of uncomplicated symptomatic urinary tract infection, a positivevalue for nitrites and leukocyte esterase by urine dipstick can be treated without the need for a urine culture. Automatedurinalysis used widely in large volume laboratories provides more sensitive detection of leukocytes andbacteria in the urine.With automated microscopy, a value of > 2 WBC/hpf is significant pyuria indicative of inflammationof the urinary tract. In complicated cases such as pregnancy, recurrent infection or renal involvement,further evaluation is necessary including manual microscopy and urine culture with sensitivities.

[学科分类] 妇产科学