Abstract
Acridine orange (AO)-stained smears of 1,042 urine specimens were examined for the presence of bacteria and compared with quantitative culture results. The detection of one or more organisms per three AO fields at X200 magnification was noted in 161 of 162 and 193 of 195 urine specimens that grew greater than 10(5) and 10(4) CFU/ml, respectively, of a clinically relevant organism. However, a high number of false-positive AO smears (356 and 324, respectively) was observed among urines that failed to grow organisms at 10(5) and 10(4) CFU/ml. Sensitivity, specificity, and positive and negative predictive values of AO smears were 99, 58, 26, and 99%, respectively, for cultures of greater than or equal to 10(5) CFU/ml and 98, 59, 32, and 99%, respectively for cultures of greater than or equal to 10(4) CFU/ml. Despite the poor specificity of the AO smear, the very high negative predictive value would allow for the ruling out of bacteriuria defined at 10(4) CFU/ml and would eliminate the need for culture of ca. 50% of the urine specimens in this study. Employment of the rapid, inexpensive AO procedure only as a means to eliminate specimens for culture would allow significant cost savings and permit the laboratory to send out a large number of potentially negative or low-count urine results within a short time of specimen receipt.
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Selected References
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- Burdash N. M., Manos J. P., Bannister E. R., Welborn A. L. Acridine orange staining and radiometric detection of microorganisms in blood cultures. J Clin Microbiol. 1983 Mar;17(3):463–465. doi: 10.1128/jcm.17.3.463-465.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cashman J. S., Boshard R., Matsen J. M. Viability of organisms held in the isolator blood culture system for 15 h and their rapid detection by acridine orange staining. J Clin Microbiol. 1983 Sep;18(3):709–712. doi: 10.1128/jcm.18.3.709-712.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Crout F. V., Tilton R. C. Rapid screening of urine for significant bacteriuria by Gram stain, acridine orange stain, and the Autobac MTS system. Diagn Microbiol Infect Dis. 1984 Jun;2(3):179–186. doi: 10.1016/0732-8893(84)90028-2. [DOI] [PubMed] [Google Scholar]
- Davis J. R., Stager C. E., Araj G. F. Clinical laboratory evaluation of a bacteriuria detection device for urine screening. Am J Clin Pathol. 1984 Jan;81(1):48–53. doi: 10.1093/ajcp/81.1.48. [DOI] [PubMed] [Google Scholar]
- Lauer B. A., Reller L. B., Mirrett S. Comparison of acridine orange and Gram stains for detection of microorganisms in cerebrospinal fluid and other clinical specimens. J Clin Microbiol. 1981 Aug;14(2):201–205. doi: 10.1128/jcm.14.2.201-205.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McCarthy L. R., Senne J. E. Evaluation of acridine orange stain for detection of microorganisms in blood cultures. J Clin Microbiol. 1980 Mar;11(3):281–285. doi: 10.1128/jcm.11.3.281-285.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mirrett S., Lauer B. A., Miller G. A., Reller L. B. Comparison of acridine orange, methylene blue, and Gram stains for blood cultures. J Clin Microbiol. 1982 Apr;15(4):562–566. doi: 10.1128/jcm.15.4.562-566.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pfaller M. A., Baum C. A., Niles A. C., Murray P. R. Clinical laboratory evaluation of a urine screening device. J Clin Microbiol. 1983 Sep;18(3):674–679. doi: 10.1128/jcm.18.3.674-679.1983. [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]
- Tierney B. M., Henry N. K., Washington J. A., 2nd Early detection of positive blood cultures by the acridine orange staining technique. J Clin Microbiol. 1983 Oct;18(4):830–833. doi: 10.1128/jcm.18.4.830-833.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]