Bacteriuria testing by the ATP method as an integral part in the diagnosis and therapy of urinary tract infection (UTI)
✍ Scribed by Lundin, A. ;Hallander, H. ;Kallner, A. ;Lundin, U. Karnell ;Österberg, E.
- Publisher
- John Wiley and Sons
- Year
- 1989
- Weight
- 702 KB
- Volume
- 4
- Category
- Article
- ISSN
- 0884-3996
No coin nor oath required. For personal study only.
✦ Synopsis
Rapid tests for bacteriuria have the highest value, if the test result is available while the patient is with the doctor. At the bacteriological laboratory rapid testing of samples obtained by mail may be cost-effective but is of little clinical value. In a previous study performed at a health care centre using conventional urine culture as a reference the ATP test came out as the most reliable one among several rapid bacteriuria tests. The present study was performed to see how the ATP test could be fitted into the routine of the health care centre. Female patients with UTI symptoms were asked to deliver a urine sample t o the health care centre laboratory and t o wait for the result before seeing the doctor. After having the symptoms confirmed the doctor based the diagnosis on the ATP value. A low ATP value ruled out UTI and a high ATP value confirmed UTI. In patients with an intermediary ATP value (lMOnmol/l) a positive nitrite test was used t o confirm UTI. Only those patients with intermediary ATP values and negative nitrite test had t o wait for conventional urine culture.
Thus in most patients the decision on antibiotic therapy or not was based on clinical symptoms and ATP results only. Antibiotics (trimethoprim) were given as single dose or as a conventional 7-day regime in a double-blind comparison. The correlation between the ATP method and conventional culture was good. Although results of the present study are promising the ATP test as performed is too complicated t o become widely accepted at health care centres. However, the dipstick version of the ATP test at present being developed will make the method ideally suited for rapid bacteriuria testing a t health care centres and similar doctor's surgery situations.