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Review of Urine Microscopy for Bacteriuria
Ronald D. Jenkins, MD;
JoAnn P. Fenn, MS;
John M. Matsen, MD
JAMA. 1986;255(24):3397-3403.
Abstract
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Urine microscopy for bacteriuria remains a useful and valid technique for the evaluation of urinary tract infection; however, established interpretive criteria are not agreed on. Our own data and a review of the literature demonstrate that reliable data can be obtained by enumerating the organisms observed in stained or unstained centrifuged and stained uncentrifuged urine specimens. Criteria are given for the interpretation of urine microscopy for maximum sensitivity and specificity for each method reviewed. For clinicians desiring to perform urine microscopy, we recommend the use of oil-immersion microscopy of Gram-stained centrifuged urine sediment and suggest that observing at least one organism per oil-immersion field corresponds with 95% sensitivity and that observing more than five organisms corresponds with 95% specificity for bacteriuria at a level of 105 or more colony-forming units per milliliter. Further testing will be required on any negative specimen from a symptomatic patient.
(JAMA 1986;255:3397-3403)
Author Affiliations
From the Departments of Internal Medicine (Dr Jenkins), Pathology (Dr Matsen and Ms Fenn), and Pediatrics (Dr Matsen), University of Utah School of Medicine, Salt Lake City.
Footnotes
Reprint requests to Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT 84132 (Dr Matsen).
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