The reliability of bioluminescence assays which employ the luciferin-luciferase ATP-dependent reaction to evaluate bacterial counts was studied, both in vitro and on urine specimens. Bioluminescence and cultural results for the most common urinary tract pathogens were analyzed. Furthermore, the influence of the culture medium, of the assaying method, and of the phase of growth on bioluminescence readings was studied. Results show that Proteus, Providencia, and Morganella strains are not correctly detected, neither in vitro nor in urine samples, by the standard assaying method. The analysis of assaying parameters demonstrated that some modifications to the extraction procedure of bacterial ATP could improve the reliability of this technique. Rapid methods to evaluate bacterial counts in biological specimens have been continuously investigated in the last 20 years (1, 4, 6, 14). The calibrated loop or the serial dilution technique is used in most cases, though they are timeconsuming (7). Methods employing the measurement of bacterial ATP by the luciferin-luciferase, ATP-dependent reaction have been developed and marketed. They were shown to be sufficiently sensitive to detect bacteria in urine specimens containing 105 CFU/ml (2, 7, 9, 11, 12). Studies performed on clinical specimens suggested different relative light unit (RLU) values (ranging from 146 to 700) as cutoff values to separate infected from noninfected urine samples. Some authors (1, 4, 7) reported 2 to 4% false-negative tests among specimens infected by Proteus mirabilis or mixed flora, but these authors did not investigate the causes of such false-negative results or evaluate the correlation between CFU-per-milliliter and RLU values on pure cultures of different bacterial species. This paper presents the results of an investigation of the causes of false-negative bioluminescence assays and the correlation between CFU-per-milliliter and RLU values for the most common urinary tract pathogens.