Abstract
A total of 3227 urine specimens were analysed to investigate the applicability of a firefly luciferase assay of microbial adenosine triphosphate (ATP) for the rapid screening of bacteriuria in clinical specimens. Urine sediment, dipslide culture, and three plate cultures were also investigated in the majority of the urine specimens, the plate cultures serving as the reference. Of the specimens with positive plate culture (≥105 colony forming units (CFU)), leucocyte content of the spun urine sediment was negative (≤4 cells per high-power field) in 34% and bacterial content was negative in 14% (no bacteria seen microscopically); the dipslide test was negative (<105 CFU) in 16%, and the luminescence assay of ATP in 7% (≥ 500 relative light units). Of the urine specimens forming less than 105 CFU on plate cultures, leucocytes were positive in 15%, spun sediment bacteria in 21%, the dipslide test in 0 · 5%, and the luminescence assay of ATP in 11%. When used as a screening test for further studies by complete culture techniques, the luminescence assay of microbial ATP can improve the rapid diagnosis of urinary tract infections.