Urinary Leukocyte Esterase Test: A Screening Method for the Detection of Asymptomatic Chlamydial and Gonococcal Infections in Men

Abstract

The ability of a urinary dipstick leukocyte esterase test (LET) to predict culture-verified asymptomatic urethral infections of Chlamydia trachomatis and Neisseria gonorrhoeae was determined in 1095 men (aged 18-39) who presented to an urban hospital for acute general medical care. Prevalence of chlamydial and gonococcal infections were 4% and 2.5% respectively; LET sensitivity was 41% and specificity was 91%. In the youngest one-third, the prevalence of infection and LET sensitivity and specificity increased to 9%, 58%, and 93%, respectively. Higher inclusion count in chlamydia culture was also significantly correlated with younger age. This is the first study to assess LET performance as a screening test for asymptomatic disease in adult men and suggests that LET has promising accuracy in young men but is less likely to be a useful screening test in men greater than 25 years old.