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Leucocyte esterase-nitrite screening method for pyuria and bacteriuria.

E G Wilkins, J G Ratcliffe, C Roberts

Journal of Clinical Pathology

|December 1, 1985

Summary

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Leucocyte esterase-nitrite strips are not effective for screening urine for pyuria or bacteriuria. While negative results are often accurate, positive results frequently lead to false positives, making the test unreliable for laboratory use.

Area of Science:

Clinical chemistry
Urology
Microbiology

Background:

Urinary tract infections (UTIs) are common and require accurate diagnosis.
Microscopy and culture are standard methods for detecting pyuria and bacteriuria.
Rapid screening tests are desirable for efficient laboratory workflows.

Purpose of the Study:

To evaluate the diagnostic accuracy of one-minute leucocyte esterase-nitrite chemical strips.
To compare the performance of these strips against microscopy and urine culture.
To determine the clinical utility of these strips as a cost-effective screening tool.

Main Methods:

Assessed the value of leucocyte esterase-nitrite strips.
Compared strip results with microscopy for pyuria (white blood cells/cu mm).

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Compared strip results with urine culture for bacteriuria (organisms/ml).

Main Results:

Negative predictive value for leucocyte esterase was 90.1% (vs. <10 white cells/cu mm).
Negative predictive value for nitrite was 91.3% (vs. <10^5 organisms/ml).
Both tests exhibited a high rate of false positives, leading to low overall predictive value for positive results.

Conclusions:

Leucocyte esterase-nitrite strips are not sufficiently sensitive or specific for reliable urine screening.
The high rate of false positives limits their effectiveness in laboratory settings.
These strips are not a cost-effective method for screening pyuria and bacteriuria.