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PubMed2003

Predicting urine culture results by dipstick testing and phase contrast microscopy.

AIMS: Urine is the most frequently received clinical specimen for bacterial culture. To determine whether dipstick or microscopy results reliably predicted the presence or absence of a reportable urinary pathogen we performed dipstick testing and phase contrast microscopy on unspun urine from 500 specimens. We also investigated the relationship between the presence of squamous epithelial cells (SECs) and mixed growth on culture. METHODS: For each specimen, the presence of leukocyte esterase and urinary nitrite was recorded as well as the quantity of leukocytes (WBC), SECs, and erythrocytes. All cultures had the number and type of each organism recorded. Pyuria was defined as > or =10 WBC/mm(3). RESULTS: Specimens with <10 SEC/mm(3) had fewer isolates (0.9 isolate per culture) than specimens with > or =10 SEC/mm(3) (two isolates per culture); therefore, SEC contamination was defined as > or =10 SEC/mm(3). Of 500 specimens, 266 (53%) had no growth and 136 (27%) had mixed growth. A total of 288 (58%) specimens had negative dipstick results and completely normal microscopy. Of these, 11 (4%) had a pure growth of a urinary pathogen but the pathogen was present in only three (1%) at > or =10(5) CFU/mL. Of 413 urine specimens without SEC contamination, 323 (78%) had either no detectable growth or pure growth compared with only 41 of 87 (47%) with SEC contamination (P<0.001). Of the 413 urine specimens without SEC contamination, 90 (22%) had > or =2 organisms compared with 46 of 87 (53%) with contamination (P<0.01). Pyuria was present in only 21 of 266 (8%) urine specimens without growth but was present in 60 of 95 (64%) specimens containing a reportable pathogen (P<0.01). CONCLUSIONS: SEC contamination does not reliably predict cultures with mixed growth, urine specimens with negative dipstick results and microscopy rarely contain a reportable urinary pathogen, and screening algorithms are warranted and justified.

Adolescent↗
PubMed1986

A blind controlled trial of phase-contrast microscopy by two observers for evaluating the source of haematuria.

Two observers, unaware of each other's findings and of the diagnosis, examined red cells in the urine of 109 patients by phase-contrast microscopy. All specimens were examined uncentrifuged by inverted microscopy, and 48 of the 109 were also examined under a light microscope after centrifugation. We were unable to confirm with either method the close correlation between red-cell morphology and diagnosis reported in previous studies, and our 2 observers differed in their interpretation on 38% of occasions. Proteinuria associated with the presence of casts in uncentrifuged urine examined by inverted microscopy was a better indication than red-cell morphology of renal parenchymal disease.

Centrifugation↗
PubMed1987

Complete staining of human spermatozoa and immature germ cells combined with phase contrast microscopy.

A method combining Janus green B and Thymol blue stains the anterior part of the head, the nuclear membrane, middle piece, and tail of spermatozoa light green and the nucleus deep purple. The method provides excellent stained preparations for the evaluation of sperm morphology by phase contrast microscopy. It produces significantly less abnormal spermatozoa compared with the Papanicolaou stain.

Azo Compounds↗
PubMed1989

[Microbial populations and periodontal condition--evaluation by differential phase contrast microscopy].

The purpose of this study was to determine correlations between various clinical assessments of inflammatory periodontal disease and the proportion of bacterial morphotypes in the subgingival flora of sites representing widely varying states of periodontal disease. Phase-contrast microscopy was used to determine the proportion of varying bacterial morphotypes at 154 sites. For each site the following clinical assessments were recorded: gingival index, probing depth, plaque index and calculus index. Statistically significant (p less than 0.01) positive correlations were found between gingival index and spirochetes or motile rods, and between probing depth and spirochetes. Significant negative correlations were found between gingival index and coccoid cells, and between probing depth and coccoid cells or rods. The significant increase in the proportion of spirochetes or motile bacteria occurred when bleeding upon probing was observed. The ratio of motile to non-motile cells at advanced disease sites was in the vicinity of 1:1. The data obtain in this study may be useful in monitoring the effects of various treatment modalities on the periodontal flora and may be helpful in determining the presence or absence of active disease.

Bacteria↗
PubMed1998

[Values of phase-contrast microscopy in the etiological diagnosis of hematuria in adults. Part I. Establishing individual norms for glomerular hematuria].

UNLABELLED: In the cohort of 123 patients (average age 44 years) criteria for glomerular and nonglomerular hematuria (H) were established by phase-contrast microscopy (PCM). According to literature, hematuria was divided into glomerular, mixed or nonglomerular if: > 60%, 20-60% and < 20% dysmorphic erythrocytes (E) of fresh morning urine sediment were found. Diagnosis of glomerulonephritis was confirmed by renal biopsy in 54/57 glomerular H as well as in all 8 cases of mixed H. On the contrary, urological reasons for H were found in 55/58 cases of nonglomerular H with normal renal biopsy in the remaining 3 patients. Using value > 20% of dysmorphic E as a new norm for glomerular H, we found sensitivity and specificity of this test as 100% and 95% respectively. IN CONCLUSION: glomerular H should be suspected and renal biopsy recommended when > 20% dysmorphic E are found by PCM what means exclusion of the term "mixed H".

Adolescent↗
PubMed1989

[Differentiation of hematuria by phase contrast microscopy studies of urine erythrocytes].

The results of phase-contrast microscopic investigations of urinary erythrocytes in 300 patients (120 patients with bioptical verified glomerulonephritis, 54 patients suffering from interstitial nephritis, 56 patients with urinary tract diseases and 70 healthy probands) are discussed. The portion of glomerular erythrocytes is dependent on diuresis, renal function and activity of glomerulonephritis. This non-invasive procedure is quick and easy practicable and its results are reliable (sensitivity and specifity of more than 90%). The proof of mainly glomerular erythrocytes save from instrumental and invasive diagnostic procedures in nephrological diseases, whereas non-glomerular erythrocytes may have an urological or hematological origin.

Adolescent↗