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Improvement of bacterial estimation in urinalysis by iQ®200 ELITE®:capture image principle urine microscopic systemKridsad...
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Improvement of bacterial estimation in urinalysis by iQ®200 ELITE®: capture image principle urine microscopic system/Kridsada31

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Kridsada Sirisabhabhorn1 Anurak Choeymang2 Supaporn Pumpa1 Krim Kamyod1 and Palakorn Puttaruk1
1Department of Medical Technology Laboratory, Thammasat University hospital, Pathumthani, Thailand
2Pharmacology and Toxicology Unit, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand

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Improvement of bacterial estimation in urinalysis by iQ®200 ELITE®: capture image principle urine microscopic system/Kridsada31

  1. 1. Improvement of bacterial estimation in urinalysis by iQ®200 ELITE®:capture image principle urine microscopic systemKridsada Sirisabhabhorn1 Anurak Choeymang2 Supaporn Pumpa1 Krim Kamyod1 and Palakorn Puttaruk11Department of Medical Technology Laboratory, Thammasat University hospital, Pathumthani, Thailand2Pharmacology and Toxicology Unit, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, ThailandThe iQ®200 urine microscopic automate analyzer system, principle in capture urine particles images has been introduced for reduction job work load unit. However,low specificity of bacteria images is problem for estimated bacteria by semi-quantitative estimation. Also, the ASP (All Small Particles) parameter and bacterial imagesbackground were used for estimated bacterial grading but interferences of some urine sediment and less experience effect to inaccurately and difficultly bacterialestimation. The objective of this study was to estimate bacteria classification by semi quantitative grading in urinalysis which using ASP parameter of iQ®200 comparedwith urine sediment centrifugation and microscopic examination. All 372 cases were estimated bacterial grading from principle of capture image and sediment centrifugeexamination immediately. Descriptive statistic was analyzed bacterial classified groups to semi quantitative as few moderate and numerous using median of ASP values.The results demonstrated that frequency bacterial estimation of iQ®200 presented as few, moderate and numerous were 96.5, 2.7 and 0.8 % respectively andmicroscopic examination were 40.59, 37.6 and 21.8% respectively, obviously uncorrelated classification. The classification of semi quantitative bacterial study considercombine with ASP values of iQ®200 were illustrated ASP’s median values to few, moderate and numerous as 1,911, 3,851 and 12,845 particles/µL respectively.Conclusion, preliminary classification of bacterial estimation with ASP particles of iQ®200 to rare, few, moderate and numerous as interval as <1,000, 1,000-3,000,3,000-8,000 and >8,000 particles/µL respectively. Benefit from the study is helpful for rapid diagnosis of bacterial estimation by iQ®200 system urine microscopicautomate analyzer system in routine urinalysis.AbstractKey words: automate analyzer, bacteria, microscopic, urinalysisIntroductionMaterials and MethodsResultsConclusion and discussionBacteriaFrequencycasesPercent(%)few 151 40.60moderate 140 37.63numerous81 21.77Total 372 100.0Urine 10 mlRemoved supernatantBacteriaFrequencycasesPercent(%)few 359 96.51moderate 10 2.69numerous 3 0.81Total 372 100.0At the present urine sediment system analyzer can help to short work flow inurinalysis. The iQ®200 urine microscopic automate analyzer system, principlecapture images of urine elements which introduce instead of conventionalurinalysis, centrifugation and observation sediments under light microscopeprocess. However, iQ®200 was presented low specific bacteria feature whichsometime made difficultly estimated bacteria volume. Many interferencesediments like shape bacteria such as mucous, amorphous, sperm, budding yeastand pseudohyphae provided false positive/negative volume of bacteria. Thusbacterial estimation was applied combine with background of elements imageand ASP (All Small Particles) values follow as recommend by product specialist.However lack of experience skill for bacteria identification induce to confuse indecision. Aim of this study was to design groups of semi-quantitative bacteriawhich related with ASP values from iQ®200ELITE® system and compare withbacteria estimation available from conventional method. The study benefit tocreated easily guideline model for bacterial grading that result fromiQ®200ELITE® in particular laboratory.iQ®200 urine microscopic automate analyzer systemConventional methodTable 1 illustrated frequency ofquantitative bacteria derived from iQ®200Table 2 illustrated frequency of quantitativebacteria available from light microscopeASP (All Small Particles) values were classified bydescriptive statisticSemi-quantitativebacteriaMedian(particles/µl)Std. Error ofMean(particles/µl)few 1,191.00 230.48moderate 3,851.50 702.61numerous 12,845.00 4,461.66Table 3. Illustrated Median (particles/µl) and Std.Error of Mean (particles/µl) of ASP values derivedfrom iQ®200 system in bacteria grading.ASP values guideline for bacterial gradingSemi-quantitative bacteria Median (particles/µl)rare <1,000few 1,000-3,000moderate 3,000-8,000numerous >8,000In table 1 and 2 were demonstrated non-relation of frequency cases in bacterial decision fromiQ®200 system and bacteria particles under microscope. Further study in ASP values each groups ofsemi-quantitative bacteria estimations as few, moderate and numerous were illustrated ASP’s median andstandard error of mean according table 3. Conclusion, in brief result of semi-quantitative bacteriaestimation were designed ASP’s values of rare, few, moderate and numerous within range of <1,000,1,000-3,000, 3,000-8,000 and >8,000 particles/µl respectively. The benefit in this study can applycombination with ASP’s values in semi quantitative bacterial estimation which responsible easy decisionand reduced turn around time per case. Furthermore this study can be used as guide line for bacteriasemi-quantitative grading which perform by iQ®200 analyzer system in urinalysis. Nevertheless, if beuncertain in difficult bacterial estimation must be confirm with microscope investigation. Finally, updatingof guideline and false positive result need to investigated in further study. Unforgettable, quality controlassurance are necessary with recommend by medical technologist always. This study declared no conflictof interest.ReferencesTable 4. Design interval range guideline of semi-quantitative bacteria grading by Median (particles/µl)derived from iQ®200 microscopic systemLinko S, Kouri TT, Toivonen E, Ranta PH, Chapoulaud E, Lalla M. Analyticalperformance of the Iris iQ 200 automated urine microscopy analyzer. ClinicaChimica Acta, 2006, 372 : 54-64.Sarvary E, Lee D, Varadi J, Varga M, Gaal I, Chmel R et al, The iQ200Microscopic Analyzer is valuable tool for evaluation of urinary sediment attransplanted patients. Intervention Medicine & Applied Science, 2010, 2: 22-6.Discrepancy of bacteria detection result with iQ®2000102030405060708090100few moderate numerous96.512.69 0.8140.6 37.6321.77Microscope iQ200®analyzerCentrifuge at 1,500 rpm 5 minLoading to iQ200 Choosing imageObservation imageAll 372 urine specimens were used in study. Firstly, prepare 10 ml of urineloaded to iQ200® then perform manual method with together. Two methods’result were analyzed by discriptive statistic.Graph 1. Comparison of cases were investigatedbacteria with 2 methods, conventional method and iQ200®.(%)frequencycasesObserved urine sediment under light microscopeMaterials and Methods

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