Evaluation of the MS-2 and Lumac Systems for the Rapid Screening of Urine Specimens

Welch, William D.; Layman, M.A.; Southern, Paul

doi:10.1016/s0022-5347(17)48826-4

Cited by 4 publications

(7 citation statements)

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“…Several recent evaluations of the Lumac system have been published (3,8,14,15). In these studies the critical parameters have ranged as follows: sensitivity, 88.9 to 96.4%; specificity, 75.0 to 88.7%; predictive value of negative results, 69.0 to 99.3%; predictive value of positive results, 50.0 to 96.0%.…”

Section: Discussionmentioning

confidence: 99%

“…Likewise, the 14 false-negative results with the clean-catch specimens also represented approximately 2% of the total 719 specimens. Of these 14,8 (approximately 60%) were also correlated with cultures contaminated by mixed flora; the remaining 6 specimens were cultured to yield a variety of organisms, with no one organism predominating.…”

Section: Methodsmentioning

confidence: 99%

“…This ATP can be detected by the bioluminescence produced in the firefly luciferin-luciferase reaction: Work with the bioluminescence ATP assay in the early and mid-1970s was discouraging due to lower sensitivities compared with the calibrated loop technique, interference from nonbacterial sources of ATP, and high cost (2). Recently, the 3M Co. has marketed the Lumac Biocounter M2010 Multi-Jet and the Lumac kit, containing reagents that selectively isolate and destroy the mammalian ATP before the actual assay of bacterial ATP. Several evaluations of this system have now been published (3,8,14,15). The types of hospitals and patient populations have varied among the different studies, as have the results.…”

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confidence: 99%

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Bioluminescence screening for bacteriuria

Kolbeck¹,

Padgett²,

Estevez³

et al. 1985

J Clin Microbiol

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A rapid screening test (45 min) for bacteriuria was evaluated in 1,000 clinical urine specimens. The test procedure is based upon firefly luciferase analysis of bacterial ATP and uses the Lumac kit and Lumac M2010 Biocounter (3M Co., St. Paul, Minn.). The procedure allows for removal and destruction of nonbacterial ATP and subsequent analysis of bacterial ATP by firefly luciferase with a single photon counter. Results, expressed in relative light units, were compared with actual CFU by the calibrated loop technique. Sensitivities and specificities were calculated separately for clean-catch midstream specimens and for urines obtained by catheterization. The sensitivity for 719 clean-catch specimens with a Lumac cutoff of 2500 relative light units, representing 2 105 CFU/ml, was 93%. The sensitivity for 281 catheterized specimens with a Lumac cutoff of 2200 relative light units, representing i104 CFU/ml, was 95%. There were 19 false-negative results in the 1,000 specimens tested; more than 50% of these were contaminated cultures and were not considered significant in determining bacteriuria. In conclusion, the Lumac bioluminescence assay is a reliable, rapid bacteriuria screening technique with the potential of reducing the laboratory cost and for reducing the turnaround time in processing negative urine cultures.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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Bioluminescence screening for bacteriuria

Kolbeck¹,

Padgett²,

Estevez³

et al. 1985

J Clin Microbiol

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“…The quantitation of bacteria was greatly improved by using buffers and reagents for the release and destruction of nonbacterial ATP in clinical urine specimens. The reported threshold for positivity was 10 5 CFU/ml, with a sensitivity of 86 to 95%, a specificity of 75 to 82%, a positive predictive value of 36 to 77%, and a negative predictive value of 88 to 95% (6,14,21,22,29,30).…”

mentioning

confidence: 99%

Rapid Antimicrobial Susceptibility Determination of Uropathogens in Clinical Urine Specimens by Use of ATP Bioluminescence

Ivančić¹,

Mastali²,

Percy³

et al. 2008

J Clin Microbiol

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We describe the first direct testing of the antimicrobial susceptibilities of bacterial pathogens in human clinical fluid samples by the use of ATP bioluminescence. We developed an ATP bioluminescence assay that eliminates somatic sources of ATP to selectively quantify the bacterial load in clinical urine specimens with a sensitivity of <1,000 CFU per milliliter. There was a log-log relationship between light emission and the numbers of CFU in clinical urine specimens. A clinical study was performed to evaluate the accuracy of the ATP bioluminescence assay for determination of the antimicrobial susceptibilities of uropathogens in clinical urine specimens tested in a blinded manner. ATP bioluminescent bacterial density quantitation was used to determine the inoculation volume in growth medium with and without antibiotics. After incubation at 37°C for 120 min, the ATP bioluminescence assay was repeated to evaluate the uropathogen response to antibiotics. The ability of the ATP bioluminescence assay to discriminate between antimicrobial susceptibility and resistance was determined by comparison of the results obtained by the ATP bioluminescence assay with the results obtained by standard clinical microbiology methods. Receiver operator characteristic curves were used to determine the optimal threshold for discriminating between susceptibility and resistance. Susceptibility and resistance were correctly predicted in 87% and 95% of cases, respectively, for an overall unweighted accuracy of 91%, when the results were stratified by antibiotic. For samples in which the pathogen was susceptible, the accuracy improved to 95% when the results for samples with less than a 25-fold increase in the amount of bacterial ATP in the medium without antibiotics were excluded. These data indicate that a rapid bioluminescent antimicrobial susceptibility assay may be useful for the management of urinary tract infections.The urinary tract is the most common organ system to experience bacterial infections (17). As a major cause of patient morbidity and health care expenditures for men and women of all age groups, urinary tract infections (UTIs) account for 7 million office visits, more than 1 million emergency room visits, and 100,000 hospitalizations each year (20). The estimated annual cost to the U.S. health care system is approximately $1.6 billion (8). Patients with nosocomial and/or complicated UTIs due to abnormal urinary tract anatomy, the presence of indwelling foreign bodies, and obstructed kidney stones are at risk for life-threatening systemic infections and permanently reduced kidney function. Patients with recurrent communityacquired, simple UTIs may incur significant treatment costs and substantial morbidity due to bothersome symptoms, such as painful urination, frequency, and urgency.The traditional basis for the evaluation of urinary tract pathogens (uropathogens) is urine culture and antibiotic susceptibility testing (13). The major drawback of the current microbiology approach is the time lapse of 2 to 3 days between s...

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“…Clinical evaluations of the systems reported sensitivities of >92% at 2105 CFU/ml and >85% at 2104 CFU/ml (2,19,26,52,54,61,62,74,86,88,89,96,97). The total cost per test for Lumac and the Monoscreen systems, which includes reagent cost, technical time, and cost of plating true and false-positives, was estimated at $2.50 or $1.77 for reagents or consumables alone, compared with $0.97 for the UTI screen.…”

Section: Colorimetric Filtrationmentioning

confidence: 99%

Detection of urinary tract infections by rapid methods.

Pezzlo¹

1988

Clinical Microbiology Reviews

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Evaluation of the MS-2 and Lumac Systems for the Rapid Screening of Urine Specimens

Cited by 4 publications

References 0 publications

Bioluminescence screening for bacteriuria

Bioluminescence screening for bacteriuria

Rapid Antimicrobial Susceptibility Determination of Uropathogens in Clinical Urine Specimens by Use of ATP Bioluminescence

Detection of urinary tract infections by rapid methods.

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