title: Dipstick leukocyte esterase activity in first-catch urine specimens. A useful screening test for detecting sexually transmitted disease in the adolescent male.
abstract: 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.
authors: Division of Adolescent/Young Adult Medicine, Children's Hospital, Boston, MA 02115.
authors: M D
authors: MD
authors: Sadof
authors: E R
authors: ER
authors: Woods
authors: S J
authors: SJ
authors: Emans
mesh_terms: D000293:Adolescent; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000652:urine; D002692:Chlamydia trachomatis; D004796:Clinical Enzyme Tests; D004950:Esterases / Q000652:urine*; D006069:Gonorrhea / Q000175:diagnosis* / Q000652:urine; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D011237:Predictive Value of Tests; D011934:Reagent Strips; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000652:urine
chemical_list: D011934:Reagent Strips; D004950:Esterases