The results of external quality assessment programme on urine leukocyte and erythrocyte counting in Poland

Ćwiklińska, Agnieszka; Kowalski, Robert; Kortas-Stempak, Barbara; Kuchta, Agnieszka; Fijałkowska, A.; Bednarczuk, Gabriela; Jankowski, Maciej

doi:10.11613/bm.2020.020707

Cited by 3 publications

(3 citation statements)

References 22 publications

(47 reference statements)

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“…There were 35% of automated measurements, with 30% performed by image-based technology and 5% by fluorescent flow cytometry. The Polish guidelines recommend that at least WBC and RBC results should be expressed as the number of particles × 10 6 /L, but the manual method still holds qualitative description for bacteria in manual examinations, including five categories ( Ćwiklińska et al., 2020 ). When the quantification values for bacteria are commonly attributed to microbiology investigations, the expressed bacterial count as the number of particles × 10 6 /L can be confusing.…”

Section: Discussionmentioning

confidence: 99%

A novel approach to screening and managing the urinary tract infections suspected sample in the general human population

Szmulik¹,

Trześniewska-Ofiara

Mendrycka

et al. 2022

Front. Cell. Infect. Microbiol.

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BackgroundAutomated urine technology providing standard urinalysis data can be used to support clinicians in screening and managing a UTI-suspected sample. Fully automated urinalysis systems have expanded in laboratory practice. Commonly used were devices based on digital imaging with automatic particle recognition, which expresses urinary sediment results on an ordinal scale. There were introduced fluorescent flow cytometry analyzers reporting all parameters quantitatively. There is a need to harmonize the result and support comparing bacteria and WBC qualitative versus semiquantitative results.MethodsA total of 1,131 urine samples were analyzed on both automated urinalysis systems. The chemical components of urinalysis (leukocyte esterase and nitrate reductase) and the sediment results (leukocytes and bacteria) were investigated as potential UTI indicators. Additionally, 106 specimens were analyzed on UF-5000 and compared with culture plating to establish cut-offs that can be suitable for standard urinalysis requirements and help to guide on how to interpret urinalysis results in the context of cultivation reflex.ResultsThe medians of bacteria counts varies from 16.2 (absence), 43.0 (trace), 443.5 (few), 5,389.2 (moderate), 19,356.6 (many) to 32,545.2 (massive) for particular digital microscopic bacteriuria thresholds. For pyuria thresholds, the medians of WBC counts varies from 0.8 (absence), 2.0 (0-1), 7.7 (2-3), 21.3 (4-6), 38.9 (7-10), 61.3 (11-15) to 242.2 (>30). Comparing the culture and FFC data (bacterial and/or WBC counts) was performed. Satisfactory sensitivity (100%), specificity (83.7%), negative predictive value (100%), and positive predictive value (75%) were obtained using indicators with the following cut-off values: leukocytes ≥40/µl or bacteria ≥300/µl.ConclusionsAccurate urinalysis gives information about the count of bacteria and leukocytes as useful indicators in UTIs, in general practice it can be a future tool to cross-link clinical and microbiology laboratories. However, the cut-off adjustments require individual optimization.

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Section: Discussionmentioning

confidence: 99%

A novel approach to screening and managing the urinary tract infections suspected sample in the general human population

Szmulik¹,

Trześniewska-Ofiara

Mendrycka

et al. 2022

Front. Cell. Infect. Microbiol.

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“…Improper storage, the duration and force of centrifugation, or the method of pellet resuspension can all affect the accuracy of the results during urine microscopy. [80][81][82] Classically, microscopy is carried out when a dipstick test urinalysis flags abnormal results. Many automated microscopic urine analyzers now remove the manual preparation steps and integrate test strip readings with automated cell counts.…”

Section: Hematuria In Other Forms Of Glomerular Diseasementioning

confidence: 99%

Glomerular Hematuria and the Utility of Urine Microscopy: A Review

Saha

Massicotte‐Azarniouch

Reynolds

et al. 2022

American Journal of Kidney Diseases

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“…In addition to conventional Internal Quality Control (IQC) programs, External Quality Assessment Schemes (EQAS) represent a key tool for the improvement of laboratory quality and are mandatory requirements in accreditation programs in all fields of laboratory medicine [3]. EQAS on urinary sediment are rare [4][5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

The Italian External Quality Assessment (EQA) program on urinary sediment by microscopy examination: a 20 years journey

Secchiero

Fogazzi

Manoni³

et al. 2020

Clinical Chemistry and Laboratory Medicine (CCLM)

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ObjectivesIn spite of the introduction of automated systems for urinary sediment analysis, microscopy examination remains the gold standard, and it is more than ever important to perform it with a good and reliable quality. External Quality Assessment (EQA) programs on urinary sediment are rare. The present paper provides an analysis of results from 2001 to date of the EQA Italian program which involves today 230 laboratories.MethodsThe program includes four surveys per year. Participants are asked the identification and clinical associations of urinary sediment particles, shown as phase contrast microscopy images in the website of the Center of Biomedical Research (CRB) (2 surveys), and the diagnosis of clinical cases presented by both images and a short clinical history (2 surveys). The results of each survey are then scored and commented. In 20 years, 298 images were presented: 90 cells (9 types), 23 lipids (5 types), 87 casts (21 types), 53 crystals (14 types), 22 microorganisms (5 types), and 23 contaminants (9 types). Moreover, 27 clinical cases, covering a wide spectrum of conditions with different degrees of complexity, were presented to participants.ResultsIdentification: among urinary particle categories, the correct identification rate (obtained for each particle from the sum of correct + partially correct answers) was very high for micro-organisms (mean ± SD: 96.2 ± 3.5%), high for lipids (88.0 ± 11.8%) and crystals (87.0 ± 16.5%) followed, in decreasing order, by cells (82.1 ± 15.9%), casts (81.8 ± 14.8%), and contaminants (76.7 ± 22.1%). Clinical associations (n=67): the rate of correct answers was 93.5 ± 5.7% ranging from 75.0 to 100% for all but one clinical association (i.e., acute glomerulonephritis: 55.4%). Clinical cases: throughout surveys, due to the overall rate of particle misidentification, only 59.8 ± 17.1%, (range 32.5–88.7%) of participants achieved access to clinical diagnosis. Of these, 88.7 ± 10.6% (range 59.9–99.3%) were able to indicate the correct diagnosis.ConclusionsOur program can be used as a tool to improve the identification of urine particles and the knowledge of their clinical meaning and to encourage specialists of laboratory medicine to correlate urinary findings with other laboratory data and the clinical history, an aspect that improves the value of the day by day work.

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The results of external quality assessment programme on urine leukocyte and erythrocyte counting in Poland

Cited by 3 publications

References 22 publications

A novel approach to screening and managing the urinary tract infections suspected sample in the general human population

A novel approach to screening and managing the urinary tract infections suspected sample in the general human population

Glomerular Hematuria and the Utility of Urine Microscopy: A Review

The Italian External Quality Assessment (EQA) program on urinary sediment by microscopy examination: a 20 years journey

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