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A L Adam

Publications and source records attributed to A L Adam.

3 recordsLinked to original sources

Performance of a urine-screening protocol.

The performance of a urinalysis protocol using screening Chemstrip-9 dipstick analysis with selective sediment microscopy and culture is reviewed. Sediment microscopy performed on urine samples positive for leukocyte esterase, nitrite, protein, or blood, or when specifically ordered (15% of urinalyses) was reduced by 57.1%. Protocol urine culture performed when more than 5 WBC/high-powered field (HPF), more than 10 bacteria/HPF, or yeasts were found on sediment microscopy or with a positive nitrite test was done for 9.8%. Urine culture was specifically ordered for another 13.6%. Percent significant bacteriuria (greater than or equal to 10(5) colony-forming units/mL) was higher for protocol-generated cultures (37.1%) versus ordered cultures (17.2%). For urinalyses with ordered cultures, the protocol would have detected 89.8% of cases with significant bacteriuria. The protocol has facilitated detection of significant bacteriuria with good acceptance by clinicians. Cost savings achieved by reduction of sediment microscopy was partly off-set by some increase in urine cultures performed.

Bacteriuria↗

Urine screening strategy employing dipstick analysis and selective culture: an evaluation.

A cost-effective urinalysis test strategy, employing screening dipstick analysis with sediment microscopy performed on urines positive for leukocyte esterase, nitrite, protein, or blood, is evaluated. Screening urine culture is done when greater than or equal to 5 WBC/HPF, greater than 10 bacteria/HPF, or yeasts are found on sediment microscopy. Predictive value, sensitivity, and specificity of the test strategy in predicting significant bacteriuria is compared with sediment microscopy, Gram staining of uncentrifuged urine and leukocyte chamber counting. Employment of the test protocol for routine urine specimens would decrease sediment microscopy by 49%, while effectively screening for significant bacteriuria with a sensitivity of 88.9% and predictive value of a negative result of 98.8%.

Bacteriological Techniques↗

Presumptive identification of Staphylococcus saprophyticus from urine specimens by colony appearance and coagulase testing: an evaluation.

Two hundred one urine specimens with pure or nearly pure cultures (greater than 5 X 10(4) CFU/mL) of coagulase-negative staphylococcus were identified in reviewing all significant urine isolates over a ten-month period. The majority of these were from young female adult outpatients with Staphylococcus saprophyticus constituting 88.9% of isolates determined with the API Staph-Ident System. For urine specimens, particularly for outpatients, coagulase-negative, nonhemolytic staphylococcal colonies with yellow pigmentation could be identified presumptively as S. saprophyticus with a sensitivity of 97.8% and a specificity of 98.3%, compared with novobiocin susceptibility testing with a sensitivity of 100% and a specificity of 96.9%.

Adolescent↗