The significance of antibody coated bacteria in neuropathic bladder urines

A total of 234 patients with neuropathic bladder dysfunction and bacteria in the urine have been studied for the presence of antibody coating on the bacteria. Approximately one third of the patients so studied were found to have antibody coated bacteria in the urine (ACB+) by fluorescent microscopy. No correlation could be found between evidence of active tissue infection by the ACB test and the age, sex or catheter status of the patient, the radiological findings or the length of time since the neurological injury. There did, however, appear to be significant differences among the bacterial species isolated, in their ability to invade through urothelium. Testing for antibody coating is a useful epidemiological tool, but is not indicated for routine use as a guide to therapy. The choice of antibacterial drugs can, in most instances, be based on the identification of the bacterial isolate and its known potential for invasion of the upper urinary tract.