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 ofchlamydial 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 >25 years old.