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February 7, 1977

Antibody-Coated Bacteria

JAMA. 1977;237(6):531. doi:10.1001/jama.1977.03270330021008

To the Editor.—  The article entitled "Lessons Learned From a Patient: Changing Concepts Rather Than Facts" by Dr. Beccia et al (236:1268, 1976) is correct in its statement that many concepts relating to urinary tract infections which are considered to be established may, in fact, be incorrect.The authors describe a patient with a community-acquired urinary tract infection in whom a diagnosis of acute pyelonephritis was suspected on the basis of clinical presentation; however, the authors suggest that the infection was limited to the lower urinary tract. This supposition appears to rest primarily on the efficacy of the immunofluorescent method for the detection of antibody-coated bacteria (ACB) in urine.We have recently completed an evaluation of the immunofluorescent method for the detection of ACB in an unselected population by the study of consecutive urine specimens submitted to the diagnostic laboratory with colony counts of 105/ml or more. The