Urine dipsticks
Leukocyte esterase test:
- Leukocyte esterase is detected as it is released from lukocytes using strips containing indoxyl carboxylic acid ester.
- 88-94% sensitive at detecting WBCs at >10/mm3
- Causes of false +/- results are here.
Nitrate reductase (Greiss test):
- Gram -ve organisms convert dietary nitrate→nitrite, which is detected in the urine.
- Positive predictive value high, but low sensitivity (only 40%-80% positives).
- Some organisms do not produce nitrate reductase:
- Enterococci
- Group B streptococci
- Pseudomonas spp.
- Other reasons for negative dipstick:
- Insufficient dietary nitrate
- Insufficient time for bacterial nitrate reductase
**MUST NOT BE USE TO TEST FOR ASYMPTOMATIC GROUP B STREP BACTERIURIA IN PREGANANCY**
AMH.
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