Literature DB >> 8039783

Unsatisfactory performance of the leukocyte esterase test of first voided urine for rapid diagnosis of urethritis.

D M Patrick1, M L Rekart, L Knowles.   

Abstract

BACKGROUND AND OBJECTIVES: The objective of this study was to determine the performance characteristics of a dipstick test for leukocyte esterase (LE), (Chemstrip 2LN, Boehringer Mannheim) in predicting the presence of urethritis and urethral pathogens in men presenting to a busy sexually transmitted disease clinic and to street outreach facilities.
METHODS: Urethral swabs for polymorphonuclear (pmn) cell count, gonorrhoea culture and chlamydia enzyme immunoassay (EIA) as well as 15 ml of first voided urine (FVU) were collected from 737 symptomatic and 726 asymptomatic men. Gonorrhoea cultures and pmn counts were processed according to standard methods. Either Abbott Chlamydiazyme EIA (confirmed) or Syva Microtrak EIA (confirmed) test was employed to detect C trachomatis. The LE test was immediately dipped in FVU, read after 60-120 seconds by the clinician and considered positive if trace, 1+ or 2+.
RESULTS: Microscopic evidence of urethritis (> or = = 4 pmn cells per 1000 x field) was found on urethral smear of 782 (53.5%) patients. Chlamydia, gonorrhoea or both were present in 104 (7.1%) patients. Performance characteristics of the LE test were as follows: (table below)
CONCLUSION: The LE test did not have adequate sensitivity to be considered a reliable rapid diagnostic test for urethritis or urethral pathogens, particularly in the asymptomatic portion of this STD clinic population.

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Year:  1994        PMID: 8039783      PMCID: PMC1195228          DOI: 10.1136/sti.70.3.187

Source DB:  PubMed          Journal:  Genitourin Med        ISSN: 0266-4348


  17 in total

1.  Detection of Chlamydia trachomatis by the polymerase chain reaction in swabs and urine from men with non-gonococcal urethritis.

Authors:  H M Palmer; C B Gilroy; B J Thomas; P E Hay; C Gilchrist; D Taylor-Robinson
Journal:  J Clin Pathol       Date:  1991-04       Impact factor: 3.411

2.  How many patients are necessary to assess test performance?

Authors:  C F Arkin; M S Wachtel
Journal:  JAMA       Date:  1990-01-12       Impact factor: 56.272

3.  Bayesian analysis of electrocardiographic exercise stress testing.

Authors:  R D Rifkin; W B Hood
Journal:  N Engl J Med       Date:  1977-09-29       Impact factor: 91.245

4.  Diagnosis and etiology of nongonococcal urethritis.

Authors:  S L Swartz; S J Kraus; K L Herrmann; M D Stargel; W J Brown; S D Allen
Journal:  J Infect Dis       Date:  1978-10       Impact factor: 5.226

5.  Urinary leukocyte esterase screening test for asymptomatic chlamydial and gonococcal infections in males.

Authors:  M A Shafer; J Schachter; A B Moscicki; A Weiss; J Shalwitz; E Vaughan; S G Millstein
Journal:  JAMA       Date:  1989-11-10       Impact factor: 56.272

6.  Noninvasive detection of Chlamydia trachomatis urethritis in men by a rapid enzyme immunoassay test.

Authors:  D G Ferris; W H Martin; D M Mathis; J C Steele; P M Fischer; K M Styslinger
Journal:  J Fam Pract       Date:  1991-07       Impact factor: 0.493

7.  Dipstick leukocyte esterase activity in first-catch urine specimens. A useful screening test for detecting sexually transmitted disease in the adolescent male.

Authors:  M D Sadof; E R Woods; S J Emans
Journal:  JAMA       Date:  1987-10-09       Impact factor: 56.272

8.  Use of a leukocyte esterase dipstick to detect Chlamydia trachomatis and Neisseria gonorrhoeae urethritis in asymptomatic adolescent male detainees.

Authors:  S F O'Brien; T A Bell; J A Farrow
Journal:  Am J Public Health       Date:  1988-12       Impact factor: 9.308

9.  Detection of leukocyte esterase in urine: a new screening test for nongonococcal urethritis compared with two microscopic methods.

Authors:  M Veeravahu; R W Smyth; J C Clay
Journal:  Sex Transm Dis       Date:  1987 Jul-Sep       Impact factor: 2.830

10.  Leucocyte esterase test as rapid screen for non-gonococcal urethritis.

Authors:  S A Perera; C Jones; V Srikantha; W Ranawickrama; M N Bhattacharyya
Journal:  Genitourin Med       Date:  1987-12
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  10 in total

1.  Comparison of urine, first and second endourethral swabs for PCR based detection of genital Chlamydia trachomatis infection in male patients.

Authors:  H Sugunendran; H D Birley; H Mallinson; M Abbott; C Y Tong
Journal:  Sex Transm Infect       Date:  2001-12       Impact factor: 3.519

2.  Is urine leukocyte esterase test a useful screening method to predict Chlamydia trachomatis infection in women?

Authors:  J M Chow; J Moncada; D Brooks; G Bolan; H Shaw; J Schachter
Journal:  J Clin Microbiol       Date:  1996-03       Impact factor: 5.948

3.  Noninvasive screening for genital chlamydial infections in asymptomatic men: Strategies and costs using a urine PCR assay.

Authors:  R W Peeling; B Toye; P Jessamine; I Gemmill
Journal:  Can J Infect Dis       Date:  1998-09

4.  Screening for chlamydial infection. Taking stock.

Authors:  J W Sellors
Journal:  Can Fam Physician       Date:  1995-02       Impact factor: 3.275

Review 5.  Current methods of laboratory diagnosis of Chlamydia trachomatis infections.

Authors:  C M Black
Journal:  Clin Microbiol Rev       Date:  1997-01       Impact factor: 26.132

6.  Sexually transmitted infections in male clients of female sex workers in Benin: risk factors and reassessment of the leucocyte esterase dipstick for screening of urethral infections.

Authors:  M Alary; C M Lowndes; L Mukenge-Tshibaka; C A B Gnintoungbé; E Bédard; N Geraldo; P Jossou; E Lafia; F Bernier; E Baganizi; J R Joly; E Frost; S Anagonou
Journal:  Sex Transm Infect       Date:  2003-10       Impact factor: 3.519

7.  Disappointing dipstick screening for urinary tract infection in hospital inpatients.

Authors:  Z Zaman; A Borremans; J Verhaegen; L Verbist; N Blanckaert
Journal:  J Clin Pathol       Date:  1998-06       Impact factor: 3.411

8.  Neutrophil enzymes in urine for the detection of urethral infection in men.

Authors:  P A Fraser; J Teasdale; K S Gan; R Eglin; S C Scott; C J Lacey
Journal:  Genitourin Med       Date:  1995-06

9.  Leucocyte esterase dip-stick test as a point-of-care diagnostic for urogenital chlamydia in male patients: A multi-center evaluation in two STI outpatient clinics in Paramaribo and Amsterdam.

Authors:  Menne Bartelsman; Henry J C de Vries; Maarten F Schim van der Loeff; Leslie O A Sabajo; Jannie J van der Helm
Journal:  BMC Infect Dis       Date:  2016-11-03       Impact factor: 3.090

Review 10.  Management of non-gonococcal urethritis.

Authors:  Harald Moi; Karla Blee; Patrick J Horner
Journal:  BMC Infect Dis       Date:  2015-07-29       Impact factor: 3.090

  10 in total

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