title: Urinary leukocyte esterase screening test for asymptomatic chlamydial and gonococcal infections in males.
abstract: 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 (greater than or equal to 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.
authors.affiliation: Department of Pediatrics, University of California, San Francisco 94143.
authors.forename: M A
authors.initials: MA
authors.lastname: Shafer
authors.forename: J
authors.initials: J
authors.lastname: Schachter
authors.forename: A B
authors.initials: AB
authors.lastname: Moscicki
authors.forename: A
authors.initials: A
authors.lastname: Weiss
authors.forename: J
authors.initials: J
authors.lastname: Shalwitz
authors.forename: E
authors.initials: E
authors.lastname: Vaughan
authors.forename: S G
authors.initials: SG
authors.lastname: Millstein
mesh_terms: D000293:Adolescent; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000652:urine; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003362:Cost-Benefit Analysis; D004950:Esterases / Q000652:urine*; D006069:Gonorrhea / Q000175:diagnosis* / Q000652:urine; D006801:Humans; D007962:Leukocytes / Q000201:enzymology*; D008297:Male; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D011237:Predictive Value of Tests; D015995:Prevalence; D011933:Reagent Kits, Diagnostic / Q000191:economics; D012725:Sexual Behavior; D014526:Urethritis / Q000175:diagnosis* / Q000382:microbiology / Q000652:urine
chemical_list: D011933:Reagent Kits, Diagnostic; D004950:Esterases