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Leucocyte esterase test as rapid screen for non-gonococcal urethritis.
S A Perera1, C Jones, V Srikantha
1Department of Genitourinary Medicine, Royal Infirmary, Manchester.
Genitourinary Medicine
|December 1, 1987
Summary
The leucocyte esterase test offers a rapid, sensitive, and objective method for screening non-gonococcal urethritis (NGU). This test effectively identifies pyuria, outperforming traditional Gram stain methods in diagnosing NGU and Chlamydia trachomatis infections.
Area of Science:
- Urology
- Infectious Diseases
- Diagnostic Medicine
Background:
- Standard non-gonococcal urethritis (NGU) diagnostic tests, Gram stain and two glass urine test, are insensitive and subjective.
- Polymorphonuclear leucocytes (PMNs) indicate inflammation; leucocyte esterase (LE) detects PMN-specific enzymes, signaling pyuria.
Purpose of the Study:
- To evaluate the leucocyte esterase (LE) test as a rapid, sensitive, and non-subjective screening tool for NGU.
- To compare the diagnostic performance of the LE test against traditional methods for NGU and Chlamydia trachomatis detection.
Main Methods:
- The study included 81 men with urethral symptoms and 40 controls.
- Urethral smears, leucocyte esterase tests, and Chlamydia trachomatis cultures were performed.
- Results were correlated with microscopic pyuria (PMNs per high power field).
Main Results:
- All 26 patients with >5 PMNs/hpf were LE positive.
- 29/55 (53%) patients with <5 PMNs/hpf were LE positive.
- 96% of Chlamydia trachomatis-positive patients were LE positive, compared to 44% for Gram stain.
- All 40 controls were LE negative.
Conclusions:
- The leucocyte esterase test is a sensitive and objective indicator of pyuria in men with urethral symptoms.
- The LE test demonstrates superior sensitivity to Gram stain for detecting NGU, especially in Chlamydia trachomatis infections.
- The LE test is a valuable rapid screening aid for NGU diagnosis.