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Urine analysis performed by flow cytometry: reference range determination and comparison to morphological findings, dipstick chemistry and bacterial culture results--a multicenter study.
Clin Nephrol. 2001 May; 55(5):384-92.CN

Abstract

AIM

To validate whether quantitative flow-cytometric analysis of particulate matter in urine would allow for accurate and rapid enumeration of red blood cells (RBC), leukocytes (WBC), squamous epithelial cells (EC), casts, and bacteria, a Sysmex UF-100 analyzer was tested in a multicenter study.

MATERIAL AND METHODS

At first, reference values were established and found to be < 14 for RBC, < 16 for WBC, < 9 for EC, < 2 for casts and < 173 for bacteria, respectively (counts per microl; 97.5 percentile). Due to the wide use of dipstick and microscopic sediment analysis in routine urine diagnostics, comparative studies on 950 random urine samples were performed. Bacterial counting combined with WBC enumeration was further compared in 266 routine urinary microbiologic cultures.

RESULTS

Good correlations were found comparing UF-100 results of RBC (r = 0.89), WBC (r = 0.94), and EC (r = 0.74) with Fuchs-Rosenthal Chamber (FRC) counts. However, some misclassification of casts (r = 0.32) could be observed. Correlations of UF-100 with dipstick and sediment testing was significant (p < 0.001), but the scatter of the latter two methods is too wide to consider them as quantitative methods. Promising results further revealed that the analyzer has a good negative predictive value (NPV) for microbiologically negative cultures, especially for cultures with bacterial counts of 10(5)/l (NPV = 95%).

CONCLUSION

The analyzer is capable of providing rapid and reliable urine analysis of cellular particles avoiding the known imprecision of dipstick and sediment methodology. Thus, when used in an algorithm, combined with dipstick or quantitative urine chemistry analysis (for hemoglobin, esterase, protein, glucose, etc.), this analyzer might serve as a rapid and accurate screening tool in routine urine analysis, thereby reducing manual reviewing rate as well as the number of missed samples, compared to screening with dipstick alone.

Authors+Show Affiliations

Central Laboratory, Kantonsspital, Basel, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Validation Study

Language

eng

PubMed ID

11393384

Citation

Regeniter, A, et al. "Urine Analysis Performed By Flow Cytometry: Reference Range Determination and Comparison to Morphological Findings, Dipstick Chemistry and Bacterial Culture Results--a Multicenter Study." Clinical Nephrology, vol. 55, no. 5, 2001, pp. 384-92.
Regeniter A, Haenni V, Risch L, et al. Urine analysis performed by flow cytometry: reference range determination and comparison to morphological findings, dipstick chemistry and bacterial culture results--a multicenter study. Clin Nephrol. 2001;55(5):384-92.
Regeniter, A., Haenni, V., Risch, L., Köchli, H. P., Colombo, J. P., Frei, R., & Huber, A. R. (2001). Urine analysis performed by flow cytometry: reference range determination and comparison to morphological findings, dipstick chemistry and bacterial culture results--a multicenter study. Clinical Nephrology, 55(5), 384-92.
Regeniter A, et al. Urine Analysis Performed By Flow Cytometry: Reference Range Determination and Comparison to Morphological Findings, Dipstick Chemistry and Bacterial Culture Results--a Multicenter Study. Clin Nephrol. 2001;55(5):384-92. PubMed PMID: 11393384.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Urine analysis performed by flow cytometry: reference range determination and comparison to morphological findings, dipstick chemistry and bacterial culture results--a multicenter study. AU - Regeniter,A, AU - Haenni,V, AU - Risch,L, AU - Köchli,H P, AU - Colombo,J P, AU - Frei,R, AU - Huber,A R, PY - 2001/6/8/pubmed PY - 2001/10/19/medline PY - 2001/6/8/entrez SP - 384 EP - 92 JF - Clinical nephrology JO - Clin Nephrol VL - 55 IS - 5 N2 - AIM: To validate whether quantitative flow-cytometric analysis of particulate matter in urine would allow for accurate and rapid enumeration of red blood cells (RBC), leukocytes (WBC), squamous epithelial cells (EC), casts, and bacteria, a Sysmex UF-100 analyzer was tested in a multicenter study. MATERIAL AND METHODS: At first, reference values were established and found to be < 14 for RBC, < 16 for WBC, < 9 for EC, < 2 for casts and < 173 for bacteria, respectively (counts per microl; 97.5 percentile). Due to the wide use of dipstick and microscopic sediment analysis in routine urine diagnostics, comparative studies on 950 random urine samples were performed. Bacterial counting combined with WBC enumeration was further compared in 266 routine urinary microbiologic cultures. RESULTS: Good correlations were found comparing UF-100 results of RBC (r = 0.89), WBC (r = 0.94), and EC (r = 0.74) with Fuchs-Rosenthal Chamber (FRC) counts. However, some misclassification of casts (r = 0.32) could be observed. Correlations of UF-100 with dipstick and sediment testing was significant (p < 0.001), but the scatter of the latter two methods is too wide to consider them as quantitative methods. Promising results further revealed that the analyzer has a good negative predictive value (NPV) for microbiologically negative cultures, especially for cultures with bacterial counts of 10(5)/l (NPV = 95%). CONCLUSION: The analyzer is capable of providing rapid and reliable urine analysis of cellular particles avoiding the known imprecision of dipstick and sediment methodology. Thus, when used in an algorithm, combined with dipstick or quantitative urine chemistry analysis (for hemoglobin, esterase, protein, glucose, etc.), this analyzer might serve as a rapid and accurate screening tool in routine urine analysis, thereby reducing manual reviewing rate as well as the number of missed samples, compared to screening with dipstick alone. SN - 0301-0430 UR - https://www.unboundmedicine.com/medline/citation/11393384/Urine_analysis_performed_by_flow_cytometry:_reference_range_determination_and_comparison_to_morphological_findings_dipstick_chemistry_and_bacterial_culture_results__a_multicenter_study_ L2 - https://medlineplus.gov/urinalysis.html DB - PRIME DP - Unbound Medicine ER -