Improved urine screening using a combination of leukocyte esterase and the Lumac system

Three rapid urine screening tests, leukocyte esterase, nitrite, and the Lumac System for detection of bacterial ATP, were evaluated alone and in combination to determine their utility in screening urine specimens from male patients for bacteruria. The combination of leukocyte esterase and Lumac testing resulted in significant improvement in the sensitivity of urine screening over each test individually and the combination of leukocyte esterase and nitrite. The leukocyte esterase/Lumac combination detected 98% of those specimens with greater than or equal to 10(5) CFU/ml and had a negative predictive value of 99%. The results obtained from this type of testing can be used with confidence to minimize the number of urine specimens cultured and to provide rapid reporting of negative results.