Reliability of pyuria detection method

The reliability of two methods for the detection of pyuria was studied in a total of 106 urine samples obtained from patients with identifiable underlying urinary tract disease. The coefficient of variation (CV) was significantly higher in the microscopic than in the counting chamber method. The CV obtained with the use of the KOVA slide 10 grid, a disposable and less expensive counting chamber, was identical to that obtained with the Bürker-Türk counting chamber. Only 50% of the patients who were proven to have pyuria of > or = 5 WBCs/HPF by the microscopic method had significant bacteriuria of > or = 10(4) bacteria per ml of urine. On the other hand, 95% and 90% of the patients who were proven to have pyuria of > or = 10 WBCs/mm3 with the Bürker-Türk and Fuchs-Rosenthal counting chambers had significant bacteriuria. It was concluded that the counting chamber provides a reliable method for the detection of pyuria and is highly predictive for the presence of significant bacteriuria. The KOVA slide 10 grid is an acceptable alternative to the regular counting chamber.