Evaluation of three bacteriuria screening methods in a clinical research hospital

In a study conducted to compare three screening methods for their ability to detect significant bacteriuria, 2,815 urine specimens were screened by Chemstrip LN (BioDynamics, Division of Boehringer Mannheim Chemicals, Indianapolis, Ind.), 1,000 were screened by Bac-T-Screen (Marion Scientific Laboratory, Kansas City, Mo.), and 289 were screened by ATP assay (Turner Designs, Mountain View, Calif.). Results were compared with those obtained by quantitative culture plate method. The ATP assay showed the highest sensitivity (91%) compared with the Bac-T-Screen (67%) and Chemstrip LN (50%) tests but had the lowest specificity (64%) compared with the Bac-T-Screen (83%) and Chemstrip LN (91%). In 101 leukopenic patients with significant bacteriuria, the Bac-T-Screen test showed a higher sensitivity (33% at 10(4) to 10(5) CFU/ml and 80% at greater than or equal to 10(5) CFU/ml). It is concluded from this study that none of the three methods are sufficiently sensitive for the clinical research patients in this institution.