Detection of lipopolysaccharide in suspected bacteriuric urine using a carbocyanine dye

Currently practiced methods for the detection of gram negative bacteriuria require culturing and overnight incubation. Such an approach to bacteriuria detection is unacceptable for any screening program which requires rapid presumptive evidence of infection. In this study, the lipopolysaccharide-dependent formation of a unique dye absorption spectra of the cationic carbocyanine dye, 1-ethyl-2-[3-(1-ethylnaphtho[1,2d]-thiazolin-2-ylidene)-2-methylpropenyl] naphtho[1,2d]-thiazolium bromide, was used to detect bacteriuria caused by gram negative organisms in a hospitalized population. In an evaluation of 168 first morning and randomly collected suspected bacteriuric urines, the dye test detected 66% of the loop plate positive urines with false positive and false negative values of 28% and 34%, respectively. However, 37% of the false positive results occurred in urines containing less than 10(5) gram negative bacteria/ml and an additional 24% of the false positives were seen for patients currently receiving antibiotic treatment. Urine specimens were also evaluated using the limulus lysate assay for lipopolysaccharide.