Abstract
Random urine specimens (848) were screened for significant bacteriuria by using the 30-min Lumac (3M, St. Paul, Minn.), the 2-min Bac-T-Screen (Marion Laboratories, Inc., Kansas City, Mo.), and the 13-h AutoMicrobic system (AMS) urine identification card (Vitek Systems, Inc., Hazelwood, Mo.). MacConkey and 5% sheep blood agar plates were inoculated with a 10(-4) dilution of urine and used for the reference method. Bac-T-Screen results were uninterpretable for 9.1% of the specimens owing to either urine sample pigmentation (5.3%) or clogging of the filter (3.8%). Screen-negative urine specimens made up 49.6, 57.2, and 48.5% of the total number of specimens evaluated with AMS, Lumac, and Bac-T-Screen, respectively. False-positive results with Lumac and Bac-T-Screen were 20.6 and 22.3%, respectively. False-negative results for cultures with greater than or equal to 10(4) CFU/ml were 22.0% with AMS, 29.4% with Lumac, and 25.5% with Bac-T-Screen, and false-negative results for cultures with greater than or equal to 10(5) CFU/ml were 29.6% with AMS, 9.9% with Lumac, and 7.0% with Bac-T-Screen. For each system, greater than 70% of false-negatives at greater than or equal to 10(5) CFU/ml consisted of mixed or pure cultures of common contaminants. With any of these screening methods, a clinically significant isolate at greater than or equal to 10(5) CFU/ml would rarely be missed (less than or equal to 1.7% for all systems). A cost-effective and rapid approach to urine microbiology could consist of screening out negative specimens by either Lumac or Bac-T-Screen and processing only screen-positive specimens by the AMS.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Alexander M. K., Khan M. S., Dow C. S. Rapid screening for bacteriuria using a particle counter, pulse-height analyser, and computer. J Clin Pathol. 1981 Feb;34(2):194–198. doi: 10.1136/jcp.34.2.194. [DOI] [PMC free article] [PubMed] [Google Scholar]
- BRENNER B. M., GILBERT V. E. Elevated levels of lactic dehydrogenase, glutamic-oxalacetic transaminase, and catalase in infected urine. Am J Med Sci. 1963 Jan;245:31–42. [PubMed] [Google Scholar]
- Brooks D., Maudar A. Pathogenesis of the urethral syndrome in women and its diagnosis in general practice. Lancet. 1972 Oct 28;2(7783):893–898. doi: 10.1016/s0140-6736(72)92532-9. [DOI] [PubMed] [Google Scholar]
- Cady P., Dufour S. W., Lawless P., Nunke B., Kraeger S. J. Impedimetric screening for bacteriuria. J Clin Microbiol. 1978 Mar;7(3):273–278. doi: 10.1128/jcm.7.3.273-278.1978. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dow C. S., France A. D., Khan M. S., Johnson T. Particle size distribution analysis for the rapid detection of microbial infection of urine. J Clin Pathol. 1979 Apr;32(4):386–390. doi: 10.1136/jcp.32.4.386. [DOI] [PMC free article] [PubMed] [Google Scholar]
- GALLAGHER D. J., MONTGOMERIE J. Z., NORTH J. D. ACUTE INFECTIONS OF THE URINARY TRACT AND THE URETHRAL SYNDROME IN GENERAL PRACTICE. Br Med J. 1965 Mar 6;1(5435):622–626. doi: 10.1136/bmj.1.5435.622. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hale D. C., Wright D. N., McKie J. E., Isenberg H. D., Jenkins R. D., Matsen J. M. Rapid screening for bacteriuria by light scatter photometry (Autobac): a collaborative study. J Clin Microbiol. 1981 Jan;13(1):147–150. doi: 10.1128/jcm.13.1.147-150.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Heinze P. A., Thrupp L. D., Anselmo C. R. A rapid (4--6-hour) urine-culture system for direct identification and direct antimicrobial susceptibility testing. Am J Clin Pathol. 1979 Feb;71(2):177–183. doi: 10.1093/ajcp/71.2.177. [DOI] [PubMed] [Google Scholar]
- Hoyt S. M., Ellner P. D. Evaluation of the Bacteriuria Detection Device. J Clin Microbiol. 1983 Oct;18(4):882–884. doi: 10.1128/jcm.18.4.882-884.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Johnston H. H., Mitchell C. J., Curtis G. D. An automated test for the detection of significant bacteriuria. Lancet. 1976 Aug 21;2(7982):400–402. doi: 10.1016/s0140-6736(76)92411-9. [DOI] [PubMed] [Google Scholar]
- Jorgensen J. H., Jones P. M. Comparative evaluation of the Limulus assay and the direct Gram stain for detection of significant bacteriuria. Am J Clin Pathol. 1975 Jan;63(1):142–148. doi: 10.1093/ajcp/63.3.142. [DOI] [PubMed] [Google Scholar]
- KASS E. H. Asymptomatic infections of the urinary tract. Trans Assoc Am Physicians. 1956;69:56–64. [PubMed] [Google Scholar]
- KASS E. H. Bacteriuria and the diagnosis of infections of the urinary tract; with observations on the use of methionine as a urinary antiseptic. AMA Arch Intern Med. 1957 Nov;100(5):709–714. doi: 10.1001/archinte.1957.00260110025004. [DOI] [PubMed] [Google Scholar]
- Kelly M. T., Balfour L. C. Evaluation and optimization of urine screening by Autobac. J Clin Microbiol. 1981 Apr;13(4):677–680. doi: 10.1128/jcm.13.4.677-680.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lewis J. F., Alexander J. Microscopy of stained urine smears to determine the need for quantitative culture. J Clin Microbiol. 1976 Oct;4(4):372–374. doi: 10.1128/jcm.4.4.372-374.1976. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MOND N. C., PERCIVAL A., WILLIAMS J. D., BRUMFITT W. PRESENTATION, DIAGNOSIS, AND TREATMENT OF URINARY-TRACT INFECTIONS IN GENERAL PRACTICE. Lancet. 1965 Mar 6;1(7384):514–516. doi: 10.1016/s0140-6736(65)92020-9. [DOI] [PubMed] [Google Scholar]
- McGeachie J., Kennedy A. C. Simplified quantitative methods for bacteriuria and pyuria. J Clin Pathol. 1963 Jan;16(1):32–38. doi: 10.1136/jcp.16.1.32. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nicholson D. P., Koepke J. A. The Automicrobic System for urines. J Clin Microbiol. 1979 Dec;10(6):823–833. doi: 10.1128/jcm.10.6.823-833.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
- PRYLES C. V., STEG N. L. Specimens of urine obtained from young girls by catheter versus voiding; a comparative study of bacterial cultures, gram stains and bacterial counts in paired specimens. Pediatrics. 1959 Mar;23(3):441–452. [PubMed] [Google Scholar]
- Pezzlo M. T., Tan G. L., Peterson E. M., de la Maza L. M. Screening of urine cultures by three automated systems. J Clin Microbiol. 1982 Mar;15(3):468–474. doi: 10.1128/jcm.15.3.468-474.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pezzlo M. T., Wetkowski M. A., Peterson E. M., de la Maza L. M. Evaluation of a two-minute test for urine screening. J Clin Microbiol. 1983 Sep;18(3):697–701. doi: 10.1128/jcm.18.3.697-701.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Resnick B., Cella R. L., Soghikian K., Lieberman A. H., Weil E. Mass detection of significant bacteriuria. An improved triphenyltetrazolium chloride (TTC) technique. Arch Intern Med. 1969 Aug;124(2):165–169. [PubMed] [Google Scholar]
- Scherstén B., Dahlqvist A., Fritz H., Köhler L., Westlund L. Screening for bacteriuria with a tet paper for glucose. JAMA. 1968 Apr 15;204(3):205–208. doi: 10.1001/jama.1968.03140160015004. [DOI] [PubMed] [Google Scholar]
- Smalley D. L., Dittmann A. N. Use of leukocyte esterase-nitrate activity as predictive assays of significant bacteriuria. J Clin Microbiol. 1983 Nov;18(5):1256–1257. doi: 10.1128/jcm.18.5.1256-1257.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stamm W. E., Counts G. W., Running K. R., Fihn S., Turck M., Holmes K. K. Diagnosis of coliform infection in acutely dysuric women. N Engl J Med. 1982 Aug 19;307(8):463–468. doi: 10.1056/NEJM198208193070802. [DOI] [PubMed] [Google Scholar]
- Stamm W. E., Wagner K. F., Amsel R., Alexander E. R., Turck M., Counts G. W., Holmes K. K. Causes of the acute urethral syndrome in women. N Engl J Med. 1980 Aug 21;303(8):409–415. doi: 10.1056/NEJM198008213030801. [DOI] [PubMed] [Google Scholar]
- Thore A., Lundin A., Anséhn S. Firefly luciferase ATP assay as a screening method for bacteriuria. J Clin Microbiol. 1983 Feb;17(2):218–224. doi: 10.1128/jcm.17.2.218-224.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]