Leukocyturia and Sexually Transmitted Infections: A Cohort Study of 2236 Asymptomatic Adults

Abstract

Background: Sexually transmitted infections (STIs) can cause leukocyturia in asymptomatic patient. We aimed to evaluate leukocyturia prevalence in asymptomatic aircrew and STIs proportion in leukocyturia. Methods: The LEUCO survey was a prospective, monocentre cohort study among aircrew, done at aeromedical center in France. Aircrews were included during five months. Systematic dipstick urinalysis leukocyturia result was collected. Participants with leukocyturia were proposed to perform a Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis, nucleic acid amplification test (NAAT). We calculated leukocyturia prevalence and STIs proportion among this. We used a logistic regression model to search for associations between leukocyturia and variables collected. This study was registered in our Institutional Review Board, number IRB 0011873202022. Findings: Between Oct 14, 2019, and Mar 13, 2020, 2236 participants performed dipstick urinalysis, of whom 127 (5.7%) had a leukocyturia. The prevalence of leukocyturia was significantly different between men, 1.9% (1.3−2.6) and women, 28.1% (23.3−33.3) (p<0.001). Female gender was associated with leukocyturia OR 21.6 (13.1−36.4) (p<0.001). In men with leukocyturia, NAAT positivity rate was very high in the 18-24 age group, 28.6% (3.7−71.0) and in the 25-34 age group, 20.0% (0.5-71.6). In women with leukocyturia, it was high in the 18-24 age group, 16.7% (4.7−37.4) and in the 25-34 age group, 18.2% (2.3−51.8). Interpretation Leukocyturia is rare in asymptomatic subjects. Patients with leukocyturia under 35 years old have high proportion of STIs. Multiplex NAAT has utility for STIs diagnosis in asymptomatic subjects under 35 years old presenting a leukocyturia. Trial Registration: Trial number IRB 0011873202022. Funding: French Army Health Service Declaration of Interest: None to declare. Ethical Approval: The survey received a favorable ethical opinion from the clinical trials validation commission of the Sainte-Anne military hospital Toulon, France, registered as an Institutional Review Board (IRB 0011873202022 ).