Skip to main content
PMC home page
Genitourinary Medicine logoLink to Genitourinary Medicine
. 1995 Jun;71(3):176–179. doi: 10.1136/sti.71.3.176

Neutrophil enzymes in urine for the detection of urethral infection in men.

P A Fraser 1, J Teasdale 1, K S Gan 1, R Eglin 1, S C Scott 1, C J Lacey 1
PMCID: PMC1195493  PMID: 7635495

Abstract

OBJECTIVES--To determine if assaying the neutrophil enzymes, neutrophil elastase (NE) and myeloperoxidase (MPO) in the urine of men attending a genitourinary medicine clinic could identify those with Neisseria gonorrhoeae or Chlamydia trachomatis infections, and those with urethritis (with or without an identified infection with either organism), and to compare the new assays with the performance of the leucocyte esterase test (LET). METHOD--100 men had urethral specimens taken for Gram-stained urethral smear, culture for N gonorrhoeae, and for C trachomatis testing by enzyme immunoassay. First-voided urines were tested for leucocyte esterase by commercial dipstick (positives were defined as greater than "trace") and then frozen at -20 degrees C prior to being assayed for NE and MPO. RESULTS--Five patients had gonorrhoea, six had chlamydia and none had both. Evidence of urethritis (> 5 polymorphonuclear leucocytes in four x 1000 fields) was found in 29 men. The results of the urine assays showed MPO levels to be non-discriminatory; however NE levels were significantly elevated in patients with proven infection or urethritis or both. Using NE values from men with no infection or urethritis an upper limit for normal was defined. Utilising this, the sensitivity of the elastase assay was calculated and found to be superior to the sensitivity of LET for detecting proven infection (64% vs 36%) and urethritis (52% vs 31%). CONCLUSIONS--Further studies of neutrophil elastase in the pathogenesis, diagnosis and treatment of urethritis are indicated.

Full text

PDF
176

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Berkley S. Diagnostic tests for sexually transmitted diseases: a challenge. Lancet. 1994 Mar 19;343(8899):685–686. doi: 10.1016/s0140-6736(94)91575-x. [DOI] [PubMed] [Google Scholar]
  2. Horner P. J., Gilroy C. B., Thomas B. J., Naidoo R. O., Taylor-Robinson D. Association of Mycoplasma genitalium with acute non-gonococcal urethritis. Lancet. 1993 Sep 4;342(8871):582–585. doi: 10.1016/0140-6736(93)91411-e. [DOI] [PubMed] [Google Scholar]
  3. Kramps J. A., van Twisk C., van der Linden A. C. L-Pyroglutamyl-L-prolyl-L-valine-p-nitroanilide, a highly specific substrate for granulocyte elastase. Scand J Clin Lab Invest. 1983 Sep;43(5):427–432. [PubMed] [Google Scholar]
  4. Kusumi R. K., Grover P. J., Kunin C. M. Rapid detection of pyuria by leukocyte esterase activity. JAMA. 1981 Apr 24;245(16):1653–1655. [PubMed] [Google Scholar]
  5. Lomas D. A., Natin D., Stockley R. A., Shahmanesh M. Chemotactic activity of urethral secretions in men with urethritis and the effect of treatment. J Infect Dis. 1993 Jan;167(1):233–236. doi: 10.1093/infdis/167.1.233. [DOI] [PubMed] [Google Scholar]
  6. McNagny S. E., Parker R. M., Zenilman J. M., Lewis J. S. Urinary leukocyte esterase test: a screening method for the detection of asymptomatic chlamydial and gonococcal infections in men. J Infect Dis. 1992 Mar;165(3):573–576. doi: 10.1093/infdis/165.3.573. [DOI] [PubMed] [Google Scholar]
  7. O'Brien S. F., Bell T. A., Farrow J. A. Use of a leukocyte esterase dipstick to detect Chlamydia trachomatis and Neisseria gonorrhoeae urethritis in asymptomatic adolescent male detainees. Am J Public Health. 1988 Dec;78(12):1583–1584. doi: 10.2105/ajph.78.12.1583. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Patrick D. M., Rekart M. L., Knowles L. Unsatisfactory performance of the leukocyte esterase test of first voided urine for rapid diagnosis of urethritis. Genitourin Med. 1994 Jun;70(3):187–190. doi: 10.1136/sti.70.3.187. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Repine J. E. Scientific perspectives on adult respiratory distress syndrome. Lancet. 1992 Feb 22;339(8791):466–469. doi: 10.1016/0140-6736(92)91067-i. [DOI] [PubMed] [Google Scholar]
  10. Sadof M. D., Woods E. R., Emans S. J. Dipstick leukocyte esterase activity in first-catch urine specimens. A useful screening test for detecting sexually transmitted disease in the adolescent male. JAMA. 1987 Oct 9;258(14):1932–1934. [PubMed] [Google Scholar]
  11. Shafer M. A., Schachter J., Moscicki A. B., Weiss A., Shalwitz J., Vaughan E., Millstein S. G. Urinary leukocyte esterase screening test for asymptomatic chlamydial and gonococcal infections in males. JAMA. 1989 Nov 10;262(18):2562–2566. [PubMed] [Google Scholar]

Articles from Genitourinary Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES