We would like to propose re-establishment of the protocol for ordering a clinical microbiology laboratory test after a bedside screening test using urine reagent strip when urinary tract infection is suspected. Media for isolation shall be chosen by the clinical microbiology laboratory after checking turbidity and microscopic examination of the urine specimen. In cases of complicated urinary tract infections, quantitative culture should be performed to investigate changes in the number of microorganism to grasp condition of super infection. In such infections, there are many cases in which multiple microorganism growth including glucose non-fermenting gram-negative bacilli can be recognized. Therefore, it is necessary to inspect colonies on media as long as possible(24hrs culture may be short in some cases). The protocol for microorganism identification and susceptibility test for such specimen varies in each laboratory, considering the Health Insurance Point System(reimbursement system by MHW).
It is necessary to communicate with physicians and to refer to past results to proceed with the laboratory test properly. Therefore, a Certified Clinical Microbiology Medical Technologist is needed and the role played by such staff is important.
[Rinsho Byori 50 : 684～687, 2002]
*Department of Laboratory Medicine, Saga Medical School Hospital, Saga 849-8501
【Key Words】complicated urinary tract infections(複雑性尿路感染症)，bacteriological examination(細菌検査)，clinical support(診療支援)
*佐賀医科大学附属病院検査部(〒849-8501 佐賀市鍋島5-1-1)
E-mail :nagasaz@post.saga-med.ac.jp