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September 24, 1982

The Antibody-Coated Bacteria Test

JAMA. 1982;248(12):1450. doi:10.1001/jama.1982.03330120020012

To the Editor.—  In their recent article in The Journal (1982;247:1723), Merritt and Keys concluded that the antibody-coated bacteria (ACB) test is unreliable in patients with neurogenic bladder dysfunction. While the sensitivity and specificity of this test are not perfect, carefully gathered data have indicated that they are better than Merritt and Keys report. I suspect that the variance of their results, specifically the four apparently false-negative ones, is the result of faulty criteria for a positive result. They have required fluorescence of most or all bacteria for the urine to be considered ACB positive. This is not a realistic definition.The criteria for a positive test result are set forth in a number of previous publications.1,2 In summary, the specimen should be designated as ACB positive if at least two uniformly fluorescent bacteria are seen in 200 site fields using a microscope with an objective magnification of ×100