소아 요로감염 진단에 있어 신속배양검사(Uricult Trio)의 유용성에 관한 연구 = Evaluation of Uricult Trio Test as a Rapid Screening of UTI in Children with Fever

다국어 초록 (Multilingual Abstract)

Purpose : The Dipslide culture test is a rapid method for diagnosis of urinary tract infection (UTI). The aim of this study is to determine the diagnostic availability of a urine Dipslide test for evaluation of UTI in febrile children.
Methods : Urine specimens from 151 febrile infants were inoculated by a routine blood agar urine culture method and the Dipslide test at the same time. Following incubation for 16-24 hours, the results of the Dipslide test were read at the next visit. Both results of Dipslide and those of routine culture were compared.
Results : The mean age of subjects was 15±10.6 months. There were 150 infants (99.3%) who had fever with a mean duration of 2.6±2.6 days. Thirty two infants (21.2%) were diagnosed as having UTI. Sensitivity and specificity of Uricult Trio CLED medium were 59.4% and 84.8%, respectively. Sensitivity and specificity of Uricult Trio E. coli medium were 60.0% and 96.2%, respectively. The Pearson correlation coefficient between results of Uricult Trio CLED medium and urine culture was 0.438 (P =0.01). Correlation between results of Uricult Trio E. coli medium and urine culture was 0.617 (P =0.01).
Conclusion : The Dipslide test requires only 16-24 hours with high specificity in terms of UTI caused by E. coli without the problems associated with specimen delay. This test seems to be helpful for exclusion of UTI in febrile infants and it may reduce unnecessary hospitalization and antibiotic use. However, further studies are required before the product can be recommended as a routine diagnostic tool.

국문 초록 (Abstract)

목 적 : 요로감염은 가장 흔한 소아기의 세균감염증의하나로 빠른 진단과 치료가 신장 합병증을 예방하기 위해 매우 중요하다. 저자들은 발열을 주소로 내원한 요로감염이 의심되는 24개월 이하의 신생아 및 영유아에서Uricult Trio 검사의 간편 검사로서의 진단적 유용성에대해 알아보고자 이 연구를 계획하였다.
방 법: 2010년 1월부터 2010년 7월까지 한일병원,경희의료원, 분당차병원 소아청소년과 외래에 발열을 주소로 내원한 24개월 이하의 환아 중 48시간 이내에 항생제 투여를 하지 않은 158명을 대상으로 하였으며 이중 검사를 위한 소변검체를 확보한 151례에서 Uricult Trio 검사와 소변배양검사를 동시에 실시하고 그 결과를비교분석 하였다.
결 과 : 대상 환아 중 요로감염으로 진단된 환아는 32명(21.2%)이었고 이 중 E. coli가 검출된 증례는 20례(66.7%)였다. Uricult Trio CLED 배지의 민감도와 특이도는 각각 59.4%, 84.8%였고 Uricult Trio E. coli 배지를 소변배양검사에서 E. coli가 동정된 증례를 비교한 결과는 민감도가 60%, 특이도가 96.2%였다. Uricult Trio CLED 배지검사와 소변배양검사간의 상관계수는0.438 (P =0.01)이었으며 Uricult Trio E. coli 배지검사와 소변배양검사간의 상관계수는 0.617 (P =0.01)로모두 통계학적으로 의미 있는 상관관계를 보였다.
결 론: Uricult Trio 검사는 소아연령의 요로감염 원인균 중 가장 흔한 원인균인 E. coli를 빠른 시간 내에 동정할 수 있는 간편 검사법이다. 이번 연구 결과 이 검사방법은 기존의 세균배양검사와의 상관관계가 의미 있게높으며 E. coli 에 의한 요로 감염시 특이도가 96.2%로높아 요로감염이 의심되는 외래환자에서 질환을 배제하는데 도움이 되고 이로 인해 발열을 주소로 내원한 외래환아에서 불필요한 입원 및 항생제 사용을 줄일 수 있을것으로 기대해본다.

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