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. 1985 Oct;22(4):531–534. doi: 10.1128/jcm.22.4.531-534.1985

Leukocyte esterase-nitrite and bioluminescence assays as urine screens.

B M Males, W R Bartholomew, D Amsterdam
PMCID: PMC268461  PMID: 3935662

Abstract

The 1-min leukocyte esterase (LE)-nitrite test (Chemstrip 9; Biodynamics, Division of Boehringer Mannheim Biochemicals, Indianapolis, Ind.) and a bioluminescence assay (Monolight centrifugation method; Analytical Luminescence Laboratory, Inc., San Diego, Calif.) were tested for their efficacy as urine screens among 453 patients at a tertiary-care teaching hospital. Both methods had the capacity to exclude significant bacteriuria (greater than or equal to 10(5) CFU/ml) when compared with the results of conventional culture methods, with predictive values of 99 and 93%, respectively, for a negative test. Bioluminescence was the more accurate nonculture method used. Sensitivity and specificity values were 97 and 71%, respectively, for bioluminescence, 82 and 60%, respectively, for LE with nitrite, and 72 and 64%, respectively, for LE without nitrite. At reduced levels of bacteriuria less than 10(5) CFU/ml), the sensitivities of LE-nitrite and bioluminescence were decreased but comparable. The addition of protein and blood test results in the Chemstrip 9, along with LE-nitrite as bacteriuria indicators, were unsatisfactory because of the large numbers of false-positive results attributed to protein and blood determinations. LE activity as detected by the LE test was a poor predictor of significant bacteriuria in both male and female patients. The sensitivity (71%) and specificity (57%) of the LE test in male patients were significantly lower than those previously reported and varied with the patient population studied.

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Selected References

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  1. Cady P., Dufour S. W., Lawless P., Nunke B., Kraeger S. J. Impedimetric screening for bacteriuria. J Clin Microbiol. 1978 Mar;7(3):273–278. doi: 10.1128/jcm.7.3.273-278.1978. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Conn R. B., Charache P., Chappelle E. W. Limits of applicability of the firefly luminescence ATP assay for the detection of bacteria in clinical specimens. Am J Clin Pathol. 1975 Apr;63(4):493–501. doi: 10.1093/ajcp/63.4.493. [DOI] [PubMed] [Google Scholar]
  3. Drow D. L., Baum C. H., Hirschfield G. Comparison of the Lumac and Monolight systems for detection of bacteriuria by bioluminescence. J Clin Microbiol. 1984 Oct;20(4):797–801. doi: 10.1128/jcm.20.4.797-801.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Hughes J. G., Snyder R. J., Washington J. A., 2nd An evaluation of a leukocyte esterase/nitrite test strip and a bioluminescence assay for detection of bacteriuria. Diagn Microbiol Infect Dis. 1985 Mar;3(2):139–142. doi: 10.1016/0732-8893(85)90023-9. [DOI] [PubMed] [Google Scholar]
  5. KASS E. H. Bacteriuria and the diagnosis of infections of the urinary tract; with observations on the use of methionine as a urinary antiseptic. AMA Arch Intern Med. 1957 Nov;100(5):709–714. doi: 10.1001/archinte.1957.00260110025004. [DOI] [PubMed] [Google Scholar]
  6. 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]
  7. Little P. J., Peddie B. A., Sincock A. R. Significance of bacterial and white cell counts in midstream urines. J Clin Pathol. 1980 Jan;33(1):58–60. doi: 10.1136/jcp.33.1.58. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Meares E. M., Jr Bacterial prostatitis vs "prostatosis". A clinical and bacteriological study. JAMA. 1973 Jun 4;224(10):1372–1375. [PubMed] [Google Scholar]
  9. Nichols W. W., Curtis G. D., Johnston H. H. Analysis of the disagreement between automated bioluminescence-based and culture methods for detecting significant bacteriuria, with proposals for standardizing evaluations of bacteriuria detection methods. J Clin Microbiol. 1982 May;15(5):802–809. doi: 10.1128/jcm.15.5.802-809.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Oneson R., Gröschel D. H. Leukocyte esterase activity and nitrite test as a rapid screen for significant bacteriuria. Am J Clin Pathol. 1985 Jan;83(1):84–87. doi: 10.1093/ajcp/83.1.84. [DOI] [PubMed] [Google Scholar]
  11. PRYLES C. V. The diagnosis of urinary tract infection. Pediatrics. 1960 Sep;26:441–451. [PubMed] [Google Scholar]
  12. Perry J. L., Matthews J. S., Weesner D. E. Evaluation of leukocyte esterase activity as a rapid screening technique for bacteriuria. J Clin Microbiol. 1982 May;15(5):852–854. doi: 10.1128/jcm.15.5.852-854.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Pezzlo M. T., Wetkowski M. A., Peterson E. M., de la Maza L. M. Evaluation of a two-minute test for urine screening. J Clin Microbiol. 1983 Sep;18(3):697–701. doi: 10.1128/jcm.18.3.697-701.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Pfaller M. A., Scharnweber G., Stewart B., Koontz F. P. Improved urine screening using a combination of leukocyte esterase and the Lumac system. Diagn Microbiol Infect Dis. 1985 May;3(3):243–250. doi: 10.1016/0732-8893(85)90036-7. [DOI] [PubMed] [Google Scholar]
  15. Sawyer K. P., Stone L. L. Evaluation of a leukocyte dip-stick test used for screening urine cultures. J Clin Microbiol. 1984 Oct;20(4):820–821. doi: 10.1128/jcm.20.4.820-821.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Schifman R. B., Wieden M., Brooker J., Chery M., Delduca M., Norgard K., Palen C., Reis N., Swanson J., White J. Bacteriuria screening by direct bioluminescence assay of ATP. J Clin Microbiol. 1984 Oct;20(4):644–648. doi: 10.1128/jcm.20.4.644-648.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Smalley D. L., Dittmann A. N. Use of leukocyte esterase-nitrate activity as predictive assays of significant bacteriuria. J Clin Microbiol. 1983 Nov;18(5):1256–1257. doi: 10.1128/jcm.18.5.1256-1257.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Smalley D. L., Doyle V. R., Duckworth J. K. Correlation of leukocyte esterase detection and the presence of leukocytes in body fluids. Am J Med Technol. 1982 Feb;48(2):135–137. [PubMed] [Google Scholar]
  19. Stamm W. E., Counts G. W., Running K. R., Fihn S., Turck M., Holmes K. K. Diagnosis of coliform infection in acutely dysuric women. N Engl J Med. 1982 Aug 19;307(8):463–468. doi: 10.1056/NEJM198208193070802. [DOI] [PubMed] [Google Scholar]
  20. Stamm W. E., Wagner K. F., Amsel R., Alexander E. R., Turck M., Counts G. W., Holmes K. K. Causes of the acute urethral syndrome in women. N Engl J Med. 1980 Aug 21;303(8):409–415. doi: 10.1056/NEJM198008213030801. [DOI] [PubMed] [Google Scholar]
  21. Thore A., Anséhn S., Lundin A., Bergman S. Detection of bacteriuria by luciferase assay of adenosine triphosphate. J Clin Microbiol. 1975 Jan;1(1):1–8. doi: 10.1128/jcm.1.1.1-8.1975. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Thore A., Lundin A., Anséhn S. Firefly luciferase ATP assay as a screening method for bacteriuria. J Clin Microbiol. 1983 Feb;17(2):218–224. doi: 10.1128/jcm.17.2.218-224.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Welch W. D., Thompson L., Layman M., Southern P. M., Jr Evaluation of two bioluminescence-measuring instruments, the Turner Design and Lumac systems, for the rapid screening of urine specimens. J Clin Microbiol. 1984 Dec;20(6):1165–1170. doi: 10.1128/jcm.20.6.1165-1170.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]

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