O INCREMENTO NO DIAGNÓSTICO DE INFECÇÕES DO TRATO URINÁRIO PELA INCLUSÃO DA COLORAÇÃO DE GRAM NA URINÁLISE
DOI:
https://doi.org/10.63845/cws37343Palavras-chave:
exame de urina; cultura de urina; infecção do trato urinário; coloração de Gram; sedimento urinárioResumo
O exame de urina é teste auxiliar para o diagnóstico de infecções do trato urinário (ITU). Esse apresenta baixa sensibilidade e especificidade na detecção de ITU e bacteriúria assintomática (BA). O estudo busca reforçar a relevância dos resultados da análise de urina com coloração de Gram nas lâminas de sedimentos de urina. Foram estudadas 235 amostras de urina coletadas em ambulatório da Faculdade de Medicina do ABC. Os resultados indicam maior positividade de ITU em exames de urina, coloração de Gram e urocultura (72,7%) no sexo masculino. Entre as amostras negativas para a cultura de urina, 11 foram positivas usando a coloração de Gram, sugerindo que esse método pode detectar ITU por bactérias exigentes ou BA. A concordância entre a coloração de Gram na urina e a cultura de urina foi de 94,98% e substancial (Kappa = 0,777), em oposição a 81,59% entre as análises de urina e cultura de urina e moderada (Kappa = 0,448). A análise de urina mostrou sensibilidade de 89,66% e especificidade de 80,48%, mas a coloração de Gram na urina mostrou 86,21% de sensibilidade e especificidade de 96,94%. A inclusão da coloração de Gram no exame de urina melhora a especificidade, aumenta a detecção de bactérias exigentes e casos de BA, levando a uma diminuição no número de falsos positivos e auxiliar na definição da antibioticoterapia sem a cultura de urina. Os resultados sugerem que a inclusão da coloração de Gram no exame de urina melhora o diagnóstico de ITU, sendo relevante em procedimentos hospitalares.
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