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Clinical and laboratory evaluation of the antibody-coated bacteria test in children
Insights
The antibody-coated bacteria test accurately identifies upper urinary tract infections in children. This method shows a strong correlation with radiological findings, unlike serum antibody titers.
Area of Science:
- Urology
- Microbiology
- Immunology
Background:
- Urinary tract infections (UTIs) are common in children, particularly those with neurogenic bladder.
- Distinguishing between upper and lower UTIs is crucial for appropriate treatment and preventing kidney damage.
- The antibody-coated bacteria (ACB) test has been proposed as a diagnostic tool.
Purpose of the Study:
- To evaluate the utility of the ACB test in differentiating upper from lower UTIs in children.
- To correlate ACB test results with radiological evidence of upper tract changes.
- To assess the relationship between serum antibody titers and ACB positivity.
Main Methods:
- Sixty-seven children with bacteriuria from urology and meningomyelocele clinics were studied.
- The ACB test was performed on urine samples.
- Radiological evidence of upper tract changes was assessed.
- Serum antibody titers to the infecting organism were measured.
Main Results:
- A strong correlation was observed between radiological evidence of upper tract changes and the presence of ACB.
- No significant correlation was found between serum antibody titers and ACB positivity.
- In vitro studies showed immediate antibody coating of homologous bacteria in urine across a wide pH range (4.0-9.0).
Conclusions:
- The ACB test is a reliable indicator of upper urinary tract involvement in pediatric UTIs.
- ACB test results correlate well with established diagnostic methods like radiology.
- Serum antibody titers are not a reliable indicator for diagnosing upper UTIs using the ACB test.
Abstract:
The antibody-coated bacteria test can distinguish upper from lower urinary tract infection. In this study 67 bacteriuric children were selected from meningomyelocele and urology clinics. There was close correlation between radiological evidence of upper tract changes and the presence of antibody-coated bacteria. There was a distinct lack of correlation between serum antibody titers to the infecting organism and antibody-coated bacteria. In vitro laboratory studies indicated that 1) antibody coating in the urine occurred immediately upon exposure of the infecting isolate to the urine of the patient, 2) only the homologous isolate was coated and 3) the pH range for antibody coating was wide (pH 4.0 to 9.0).