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October 9, 1987, Vol 258, No. 14 >
ARTICLE | October 9, 1987

Dipstick Leukocyte Esterase Activity in First-Catch Urine Specimens: Title and subTitle BreakA Useful Screening Test for Detecting Sexually Transmitted Disease in the Adolescent Male FREE

Matthew D. Sadof, MD; Elizabeth R. Woods, MD, MPH; S. Jean Emans, MD
[+] Author Affiliations

Reprint requests to Division of Adolescent/Young Adult Medicine, The Children's Hospital, 300 Longwood Ave, Boston, MA 02115 (Dr Emans).


JAMA. 1987;258(14):1932-1934. doi:10.1001/jama.1987.03400140094032
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Although sexually active female adolescents are often routinely screened for sexually transmitted diseases, indications for culturing adolescent males for sexually transmitted urethral infections are controversial. A study of 54 sexually active males (14 to 22 years old) was undertaken to assess the reliability of using dipstick leukocyte esterase activity in first-catch urine specimens to detect urethritis caused by Neisseria gonorrhoeae and Chlamydia trachomatis. Eighteen males had sexually transmitted diseases: N gonorrhoeae (nine patients), C trachomatis (eight patients), and N gonorrhoeae and C trachomatis (one patient). First-catch urine specimens with a 1 + (mild) or 2 + (moderate) reaction on dipstick testing had a leukocyte (WBC) count of 10 WBCs per high-power field or greater on microscopic analysis, with an 83% sensitivity, 100% specificity, a 100% positive predictive value, and a 92% negative predictive value for the presence of N gonorrhoeae, C trachomatis, or both. Clinical criteria for screening (urethral discharge, dysuria, or exposure to a sexually transmitted infection) plus a dipstick-positive first-catch urine specimen had a 94% sensitivity, 89% specificity, an 81% positive predictive value, and a 97% negative predictive value.

(JAMA 1987;258:1932-1934)

REFERENCES

1 +
Washington A, Sweet R, Shafer M:  Pelvic inflammatory disease and its sequelae in adolescents . J Adolesc Health Care 1985;;6:298-310.
2 +
Stamm WE, Koutksy LA, Benedetti JK, et al:  Chlamydia trachomatis urethral infections in men: Prevalence, risk factors, and clinical manifestations . Ann Intern Med 1984;;100:47-51.
3 +
Smith J, Linder C, Jay S, et al:  Isolation of Neisseria gonorrhoeae from the urethra of asymptomatic adolescent males . Clin Pediatr 1986;;25: 566-568.
4 +
Desai K, Robson H:  Comparison of Gramstained urethral smear and first-void urine sediment in the diagnosis of non gonococcal urethritis . Sex Transm Dis 1982;;9:21-25.
5 +
Adger H, Shafer MA, Sweet R, et al:  Screening for Chlamydia trachomatis and Neisseria gonorrhoeae in adolescent males: Value of first catch urine examination . Lancet 1984;;2:944-945.
6 +
Podgore J, Holmes K, Alexander E:  Asymptomatic urethral infections due to Chlamydia trachomatis urethritis in male US military personnel . J Infect Dis 1982;;146:828.
7 +
SAS User's Guide . Cary, NC, SAS Institute Inc, 1982;.
8 +
Cohn J: Statistical Power Analysis for the Social Sciences . Orlando, Fla, Academic Press Inc, 1977;.
9 +
Banauch D:  Leukozyten-Nachweis im Urin mit einem Test streifen: Eine kooperative Studied en elf Zentren . Dtsch Med Wochenschr 1979;;104:1236-1240.
10 +
Kusumi RK, Grover PJ, Kunin CM:  Rapid detection of pyuria by leukocyte esterase activity . JAMA 1981;;16:1653-1655.
11 +
Gillenwater JY:  Detection of urinary leukocytes by Chemstrip-L . J Urol 1981;;125:383-384.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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1 +
Washington A, Sweet R, Shafer M:  Pelvic inflammatory disease and its sequelae in adolescents . J Adolesc Health Care 1985;;6:298-310.
2 +
Stamm WE, Koutksy LA, Benedetti JK, et al:  Chlamydia trachomatis urethral infections in men: Prevalence, risk factors, and clinical manifestations . Ann Intern Med 1984;;100:47-51.
3 +
Smith J, Linder C, Jay S, et al:  Isolation of Neisseria gonorrhoeae from the urethra of asymptomatic adolescent males . Clin Pediatr 1986;;25: 566-568.
4 +
Desai K, Robson H:  Comparison of Gramstained urethral smear and first-void urine sediment in the diagnosis of non gonococcal urethritis . Sex Transm Dis 1982;;9:21-25.
5 +
Adger H, Shafer MA, Sweet R, et al:  Screening for Chlamydia trachomatis and Neisseria gonorrhoeae in adolescent males: Value of first catch urine examination . Lancet 1984;;2:944-945.
6 +
Podgore J, Holmes K, Alexander E:  Asymptomatic urethral infections due to Chlamydia trachomatis urethritis in male US military personnel . J Infect Dis 1982;;146:828.
7 +
SAS User's Guide . Cary, NC, SAS Institute Inc, 1982;.
8 +
Cohn J: Statistical Power Analysis for the Social Sciences . Orlando, Fla, Academic Press Inc, 1977;.
9 +
Banauch D:  Leukozyten-Nachweis im Urin mit einem Test streifen: Eine kooperative Studied en elf Zentren . Dtsch Med Wochenschr 1979;;104:1236-1240.
10 +
Kusumi RK, Grover PJ, Kunin CM:  Rapid detection of pyuria by leukocyte esterase activity . JAMA 1981;;16:1653-1655.
11 +
Gillenwater JY:  Detection of urinary leukocytes by Chemstrip-L . J Urol 1981;;125:383-384.

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