Hellerstein et al have compiled interesting data that support the findings of Jodal et al,1 indicating a lack of correlation between ACB in the urine sediment and the site of infection within the urinary tract in children. A positive test result for ACB was found in a number of children whose infections localized to the lower urinary tract. We do not understand why the results in adult women are at variance with those in children.
We agree that the tests should be standardized. We have shown to our satisfaction that the presence of only a few brightly fluorescent organisms is compatible with renal infection. In many instances, relatively small numbers of perhaps less than 1% of those present in the voided urine originated within the renal parenchyma. Our criteria for a positive test was a relatively small number of uniformly fluorescing organisms. Schaberg et al2 have
Harding GKM, Ronald AR. Urinary Tract Infection Localization in Women-Reply. JAMA. 1979;241(8):789–790. doi:10.1001/jama.1979.03290340013006