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A new in vitro method was developed which enabled isolation and identification of ACB-positive bacteria in polymicrobial renal bacteriuria. This approach was used in 16 patients with permanent nephrostomies and asymptomatic bacteriuria who had shown positive ACB test by the method of Thomas et al. A total of 48 urinary isolates were obtained from these patients in which 21 (43.8%) were revealed as being positive by the present method. In 13 of the 16 patients, there was only one positive species among several species of bacteria. The species with a colony count of more than 10(5)/ml was found to be most commonly ACB positive (71.5%). Of the 13 patients who had creatinine clearance tests available, 11 (84.6%) showed a considerable decrease in renal function after the intervals since nephrostomy. The immunologically different characteristics observed among multiple bacterial species in polymicrobial renal bacteriuria suggest a possible aggressive role for the ACB-positive species and therefore a need for eradicating them.
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