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Urinary nitrite and urinary-tract infection.

G P James, K L Paul, J B Fuller

American Journal of Clinical Pathology

|October 1, 1978

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Urinary nitrite tests can yield false negatives. Factors like ascorbic acid, urobilinogen, and low pH can interfere with nitrite detection, even with high bacterial counts.

Area of Science:

Clinical Chemistry
Microbiology
Urology

Background:

Urinary nitrite tests are common diagnostic tools.
High bacterial counts in urine can indicate infection.
False-negative results can delay diagnosis and treatment.

Purpose of the Study:

To investigate factors causing false-negative urinary nitrite results.
To evaluate the reliability of nitrite assays in clinical settings.

Main Methods:

Analyzed 786 urine samples using dipstick and automated assays.
Assessed the impact of bacterial load on nitrite detection.
Investigated in vitro nitrite degradation and interfering substances.

Main Results:

Related Experiment Videos

Limited nitrate concentration was not a primary cause of false negatives.
Nitrite was lost in vitro at high bacterial counts (>100,000 organisms/ml).
Ascorbic acid, urobilinogen, and low urinary pH (<6.0) can cause false negatives.

Conclusions:

Urinary nitrite assays can produce false negatives.
Bacterial load and specific urine components interfere with test accuracy.
Clinical interpretation requires consideration of these interfering factors.