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Urinary Leukocyte Esterase Screening Test for Asymptomatic Chlamydial and Gonococcal Infections in Males

Mary-Ann Shafer, MD; Julius Schachter, PhD; Anna Barbara Moscicki, MD; Anna Weiss, PhD; Janet Shalwitz, MD; Elaine Vaughan, PhD; Susan G. Millstein, PhD
JAMA. 1989;262(18):2562-2566. doi:10.1001/jama.1989.03430180104038.
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We evaluated the ability of the urinary leukocyte esterase test to predict culture-verified chlamydial and gonococcal urethritis among asymptomatic adolescent males. Nine hundred forty-eight sexually active males provided first-catch urine samples for esterase screening, and 76 (8%) tested positive (≥1 + ). Among 435 boys who agreed to undergo urethral culture, the esterase was positive in 66 (15%), Chlamydia trachomatis was isolated from 39 (9%), and Neisseria gonorrhoeae was isolated from 14 (3%). The sensitivity, specificity, and positive and negative predictive values for the esterase test were 72%, 93%, and 58% and 96%, respectively. Using the esterase test to screen asymptomatic males for urethritis, we identified 38 culture-verified infections that otherwise would have remained undetected. The urinary leukocyte esterase test is a noninvasive and cost-effective screening method to detect urethritis among asymptomatic adolescent males.

(JAMA. 1989;262:2562-2566)

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