尿培養検査の省略提案条件の設定と実施効果  [in Japanese] Establishment of exclusion criteria for urine culture and its effects  [in Japanese]

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Author(s)

    • 平良 ひかり TAIRA Hikari
    • 地方独立行政法人那覇市立病院医療技術部検査室 Division of Clinical Laboratory, Department of Medical Technology, Naha City Hospital
    • 大城 健哉 OHSHIRO Takeya
    • 地方独立行政法人那覇市立病院医療技術部検査室 Division of Clinical Laboratory, Department of Medical Technology, Naha City Hospital
    • 宮城 ちひろ MIYAGI Chihiro
    • 地方独立行政法人那覇市立病院医療技術部検査室 Division of Clinical Laboratory, Department of Medical Technology, Naha City Hospital
    • 真栄田 百合子 MAEDA Yuriko
    • 地方独立行政法人那覇市立病院医療技術部検査室 Division of Clinical Laboratory, Department of Medical Technology, Naha City Hospital

Abstract

<p>尿培養検査は尿路感染症の診断に重要な検査であり,細菌培養検査の材料内訳でも多くを占めるが,培養陰性検体も多いのが現状である。今回,尿培養検査の効率化を目的として,全自動尿中有形成分分析装置UF-1000i(シスメックス株式会社,以下UF)の結果と検体性状に基づく尿培養検査の省略提案条件を設定し,経費削減効果も確認した。尿培養検査の省略提案は「透明尿かつUFで細菌陰性かつ白血球陰性」と設定した。尿培養検査の省略提案開始後の2016年10月から2018年7月の間に243件の尿培養が省略された。経費削減効果として,培地費用だけで合計55,161円の経費削減の効果が得られ,関連する物品経費や労働力の削減などの波及効果も得られたと考えられた。一方,患者背景を考慮せずにUF結果や検体性状のみで自動的に培養を省略すると,臨床的な尿路感染症を見逃す可能性がある。そのため,医師に確認し,尿培養が必要であると判断された場合は実施するべきであると考える。今回の検討で,UF結果と検体性状を考慮することにより不要な尿培養検体の選別が可能であることが示された。UF結果で尿路感染を示す所見が認められなかった場合,尿培養検査を省略することは労働力および経済面で利点がある。</p>

<p>Urine culture is an important test for the diagnosis of urinary tract infection, and it accounts for a large proportion of culture specimens. However, many urine culture specimens show a negative result. To improve the efficiency of urine culture tests, conditions for exclusion of urine cultures were examined on the basis of a specimen's properties and the automated urinary flow cytometer UF-1000i (Sysmex) results. We also investigated the cost-saving effects of the establishment of exclusion criteria. The conditions for exclusion of a urine culture were set as "transparent urine with leukocyte-negative and bacteria-negative by UF-1000i results". A total of 243 urine cultures were excluded during the period from October 2016 to July 2018. The cost benefit due to the reduced amount of medium used reached 55,112 JPY. It was speculated that there were additional cost benefits from the reductions in the amounts of related materials and labor. However, the automatic exclusion of urine cultures without consideration of patient background carries a risk of overlooking clinical urinary tract infection. Therefore, a urine culture should only be excluded with a doctor's permission. In this study, it was shown that urine culture specimens that can be excluded can be identified by considering the UF-1000i results and specimen properties. In the absence of urinary tract infection indicated by UF-1000i results, excluding urine cultures has advantages in terms of labor and cost reductions.</p>

Journal

  • Japanese Journal of Medical Technology

    Japanese Journal of Medical Technology 68(3), 450-454, 2019

    Japanese Association of Medical Technologists

Codes

  • NII Article ID (NAID)
    130007684196
  • Text Lang
    JPN
  • ISSN
    0915-8669
  • Data Source
    J-STAGE 
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