Abstract
The development of practical and rapid methods for detection of infectious-disease-producing agents in clinical specimens is the most important current goal of clinical microbiology. Bioluminescence is a technique which is rapid and potentially sensitive enough to detect significant numbers of bacteria in urine specimens. To determine whether bioluminescence is practical and cost effective for routine use, we compared two commercially available instruments and kits, Lumac and Monolight, to standard bacterial cultures on 986 urine specimens. Lumac had an overall 83.7% agreement with cultures, a sensitivity of 92.4%, and a specificity of 79.4%. Monolight had 83.5% agreement with cultures, a sensitivity of 89.1%, and a specificity of 81.8%. There were 13.8% false-positive results and 2.5% false-negative results with both systems. When only potentially significant organisms were included, the false-negative rate was reduced to ca. 1%. Both systems are sufficiently accurate to be recommended for routine use. The cost of bioluminescence is higher than that of bacterial cultures, and bioluminescence may not be cost effective in some laboratories.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Alexander D. N., Ederer G. M., Matsen J. M. Evaluation of an adenosine 5'-triphosphate assay as a screening method to detect significant bacteriuria. J Clin Microbiol. 1976 Jan;3(1):42–46. doi: 10.1128/jcm.3.1.42-46.1976. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Conn R. B., Charache P., Chappelle E. W. Limits of applicability of the firefly luminescence ATP assay for the detection of bacteria in clinical specimens. Am J Clin Pathol. 1975 Apr;63(4):493–501. doi: 10.1093/ajcp/63.4.493. [DOI] [PubMed] [Google Scholar]
- Hoban D. J., Koss J. C., Gratton C. A., Ronald A. R. Urine screening with the MS-2. J Clin Microbiol. 1983 Jun;17(6):1061–1065. doi: 10.1128/jcm.17.6.1061-1065.1983. [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]
- Mackett D., Kessock-Philip S., Bascomb S., Easmon C. S. Evaluation of the Lumac kit for the detection of bacteriuria by bioluminescence. J Clin Pathol. 1982 Jan;35(1):107–110. doi: 10.1136/jcp.35.1.107. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McWalter P. W., Sharp C. A. Evaluation of a commercially available semi-automated bioluminescence system for bacteriuria screening. Eur J Clin Microbiol. 1982 Aug;1(4):223–227. doi: 10.1007/BF02019712. [DOI] [PubMed] [Google Scholar]
- Nichols W. W., Curtis G. D., Johnston H. H. Analysis of the disagreement between automated bioluminescence-based and culture methods for detecting significant bacteriuria, with proposals for standardizing evaluations of bacteriuria detection methods. J Clin Microbiol. 1982 May;15(5):802–809. doi: 10.1128/jcm.15.5.802-809.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thore A., Anséhn S., Lundin A., Bergman S. Detection of bacteriuria by luciferase assay of adenosine triphosphate. J Clin Microbiol. 1975 Jan;1(1):1–8. doi: 10.1128/jcm.1.1.1-8.1975. [DOI] [PMC free article] [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]