Correlations between ancillary assays and bacteriuria in children with myelodysplasia and ileal conduit urinary diversions.

Urine from children with ileal conduit urinary diversions was assayed for antibody-coated bacteria, lysozyme and lactic dehydrogenase isoenzymes, and correlated with the results of quantitative urine culture. A significant proportion of the antibody-coated bacteria and lysozyme assays were positive when more than 10(4) organisms per ml. of urine were found. Lactic dehydrogenase isoenzyme results were frequently at variance with the other assay and culture results. Because none of the ancillary assays was invariably positive in patients with symptoms suggestive of upper tract disease, they remain imperfect research tools for localization of urinary tract infections in patients with ileal conduits. In this patient population quantitative urine culture remains the best clinical method for diagnosing urinary tract infections and evaluating the adequacy of antibiotic therapy. However, since the antibody-coated bacteria and lysozyme assays converted to negative with successful treatment, these tests may provide additional guidance to the physician in assessing the adequacy of treatment of urinary tract infections in patients with ileal conduit diversions.