Urinary tract infection in patients with acute non-gonococcal urethritis.
In young sexually active male patients, clinical differentiation between non-gonococcal urethritis (NGU) and urinary tract infection (UTI) can be difficult. UTI as a cause of NGU has been suggested before, but the prevalence of UTI among acute NGU patients has not been evaluated. We conducted a prospective cross-sectional study of 156 male patients with clinical features of acute urethritis. The prevalence of UTI among acute NGU patients was 6.4% (CI: 1.5-11.3%). There was a possible association between UTI and NGU but this was not statistically significant. The sensitivity and specificity for combining leucocyte esterase and nitrite tests were 83.3% and 89.8%, respectively, with a negative predictive value of 98.8%. We conclude that a mid-stream urine specimen should routinely be collected in patients with symptoms of urethritis. This should be analysed by dipsticks incorporating nitrite and leucocyte esterase tests. Those with a positive dipstick should then be confirmed by culture.
Leung
Andrew
A
Department of Genitourinary Medicine, Milne Sexual Health Centre Bristol Royal Infirmary, Bristol, UK. askleung@btinternet.com
Taylor
Shaw
S
Smith
Angela
A
Spencer
Robert
R
Horner
Paddy
P
D000208:Acute Disease; D002265:Carboxylic Ester Hydrolases / Q000652:urine*; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D008297:Male; D009573:Nitrites / Q000652:urine*; D015995:Prevalence; D011446:Prospective Studies; D011934:Reagent Strips; D012680:Sensitivity and Specificity; D006113:United Kingdom / Q000453:epidemiology; D014526:Urethritis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology
D009573:Nitrites; D011934:Reagent Strips; D002265:Carboxylic Ester Hydrolases