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Urine Leukocyte Esterase

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1. Utility of the Urine Reagent Strip Leukocyte Esterase Assay for the Diagnosis of Meningitis in Resource-Limited Settings: Meta-Analysis. (PubMed)

Utility of the Urine Reagent Strip Leukocyte Esterase Assay for the Diagnosis of Meningitis in Resource-Limited Settings: Meta-Analysis. Diagnosis of bacterial meningitis often requires cytometry, chemistry and/or microbiologic culture capabilities. Unfortunately, laboratory resources in low-resource settings (LRS) often lack the capacity to perform these studies. We sought to determine whether the presence of white blood cells in CSF detected by commercially available urine reagent strips (...) could aid in the diagnosis of bacterial meningitis.We searched PubMed for studies published between 1980 and 2016 that investigated the use of urine reagent strips to identify cerebrospinal fluid (CSF) pleocytosis. We assessed studies in any language that enrolled subjects who underwent lumbar puncture and had cerebrospinal fluid testing by both standard laboratory assays and urine reagent strips. We abstracted true-positive, false-negative, false-positive and true-negative counts for each study

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2017 Tropical medicine & international health : TM & IH

2. Urine Leukocyte Esterase

Urine Leukocyte Esterase Urine Leukocyte Esterase Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Urine Leukocyte Esterase Urine (...) Leukocyte Esterase Aka: Urine Leukocyte Esterase II. Mechanism Neutrophil s contain esterases Positive test suggests pyuria Dipstick requires 5 minutes to change color III. Normal Negative IV. Abnormal: Positive Vaginal contaminant V. Causes: False negative Leukocyte esterase on Urinalysis Inadequate time allowed for dipstick reading Increased present ( ) s present (Ketonuria) VI. Causes: Positive Leukocyte esterase and negative culture urealyticum Urinary tract foreign body Medications ( , Cytoxan

2018 FP Notebook

3. Leukocyte esterase, glucose and C-reactive protein in the diagnosis of prosthetic joint infections: a prospective study. (PubMed)

Leukocyte esterase, glucose and C-reactive protein in the diagnosis of prosthetic joint infections: a prospective study. Analysis of joint fluid is of paramount importance for the diagnosis of prosthetic joint infections. Different markers of inflammation and/or infection in joint fluid have been proposed for diagnosis of these infections. In this study we evaluated the performance of leucocyte esterase, C-reactive protein (CRP) and glucose assays in synovial fluids from 129 patients (...) with septic (n = 27) or aseptic (n = 102) prosthetic joint failure. Samples were collected in serum tubes and centrifuged to limit the presence of corpuscle interfering with the assays. Determinations of leucocyte esterase and glucose were carried out by means of enzymatic colorimetric reactions performed on strips for urine analysis. Tests were considered positive when graded + or ++ whereas traces or absence of colour were considered negative. CRP was measured using an automated turbidimetric method

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2016 Clinical Microbiology and Infection

4. Urine Leukocyte Esterase

Urine Leukocyte Esterase Urine Leukocyte Esterase Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Urine Leukocyte Esterase Urine (...) Leukocyte Esterase Aka: Urine Leukocyte Esterase II. Mechanism Neutrophil s contain esterases Positive test suggests pyuria Dipstick requires 5 minutes to change color III. Normal Negative IV. Abnormal: Positive Vaginal contaminant V. Causes: False negative Leukocyte esterase on Urinalysis Inadequate time allowed for dipstick reading Increased present ( ) s present (Ketonuria) VI. Causes: Positive Leukocyte esterase and negative culture urealyticum Urinary tract foreign body Medications ( , Cytoxan

2015 FP Notebook

5. Urine Testing in Long-Term Care

identified. Additional references of potential interest are provided in the appendix. OVERALL SUMMARY OF FINDINGS One non-randomized study 1 compared the validity of multi-reagent strips with standard urinalysis for the early detection of urinary tract infection (UTI) in long-term care (LTC) residents. Urine samples were tested for leukocyte esterase and nitrite. Dipstick tests that were positive for leukocyte esterase or nitrite were not specific indicators of a UTI and had high false negative rates (...) . The authors concluded that dipstick tests alone were not suitable for screening residents for UTI. A second non-randomized study 3 compared dipstick analysis for leukocyte esterase and nitrite with urine culture. The authors suggested using both dipsticks and determined that, when both dipstick tests were negative, the presence of pathogenic bacteria could be ruled out with a negative predictive value of 88%. One non-randomized study 2 aimed to identify clinical features that could be used to identify UTI

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

6. Clinical usefulness of iQ200/iChem Velocity workstation for screening of urine culture. (PubMed)

total of 1942 urine specimens were processed through both culture and iQ200/ iChem workstation. We analyzed the performance using two definition of positive urine culture; one or two potential uropathogens at a concentration of ≥105 CFU/ml and ≥ 104 CFU/ml. We assessed combinations of parameters (ASP; all small particles, WBC; leukocyte, BACT; bcteria, LE; leukocyte esterase) applying various cut-offs which can achieve the negative predictive value (NPV) ≥97% and culture reduction rate ≥ 50 (...) Clinical usefulness of iQ200/iChem Velocity workstation for screening of urine culture. Clinical microbiology laboratories are asked to process large numbers of urine specimens for culture, but only 20-40% of them are positive. Therefore, a rapid, reliable screening method is necessary to speed up the reporting of a negative result. In this study, we evaluated the iQ200/iChem workstation, which is a combination of digital imaging software and a strip reader to predict negative urine culture.A

2019 BMC Infectious Diseases

7. Fast and Sensitive: Automated Point-of-Care Urine Dips. (PubMed)

retrospective chart review was conducted on patients (aged birth through 18 years) presenting to a PED between January 2015 and December 2015. Eligible subjects included those that had a POC dip, laboratory urinalysis (lab UA), and urine culture performed during their PED visit. Subjects were selected, using a random number generator; 334 charts were selected. A positive POC dip was defined as having a positive leukocyte esterase or the presence of nitrites. A positive lab UA was defined as having (...) a positive leukocyte esterase, nitrites, or greater than 10 white blood cells per high-power field. Urine culture was used as the criterion standard for comparison.A total of 334 subjects' charts were reviewed. Sensitivity and specificity of the POC dip were 91.4% (95% confidence interval [CI], 76.9%-98.2%) and 63.9% (95% CI, 57.2%-69.3%); lab UA, 91.4% (95% CI, 76.9%-98.2%) and 63.9% (95% CI, 58.2%-69.3%); and lab dip, 88.6% (95% CI, 73.3%-96.8%) and 65.6% (95% CI, 59.9%-70.9%).Point-of-care dips

2017 Pediatric Emergency Care

8. Cath or bag? Bag then cath? Urine testing options in the ED

of reducing the number of urine catheterizations being performed. Patients in the ED with a complaint of fever between the ages of 6-24 months were risk stratified (see attached table below from study). Patients determined to be at increased risk had urine bags placed by a nurse on arrival to an ED room. Urinalysis was performed at the discretion of the clinician after exam and full history obtained. If the urinalysis was positive for moderate or large leukocyte esterase or contained nitrites, the child (...) Cath or bag? Bag then cath? Urine testing options in the ED Cath or bag? Bag then cath? Urine testing options in the ED – PEMBlog Search for: Search for: Jane M. Lavelle, MD, Mercedes M. Blackstone, MD, Mary Kate Funari, MSN, RN, CPEN, Christine Roper, BSN, RN, CPEN, Patricia Lopez, MSN, CPNP-PC, Aileen Schast, PhD, April M. Taylor, MS, MHA, Catherine B. Voorhis, BS, Mira Henien, BS, Kathy N. Shaw, MD, MSCE Pediatrics, July 2016 The overall goal of this study was to investigate the possibility

2017 PEM Blog

9. The Importance of Urine Concentration on the Diagnostic Performance of the Urinalysis for Pediatric Urinary Tract Infection. (PubMed)

The Importance of Urine Concentration on the Diagnostic Performance of the Urinalysis for Pediatric Urinary Tract Infection. The presence of leukocyte esterase by urine dipstick and microscopic pyuria are both indicators of possible urinary tract infection. The effect of urine concentration on the diagnostic performance of the urinalysis for pediatric urinary tract infection has not been studied. Our objective is to determine whether the urinalysis performance for detecting urinary tract (...) to 1.030, and >1.030).In total, 14,971 cases were studied. Median age was 1.5 years (interquartile range 0.4 to 5.5 years) and 60% were female patients. Prevalence of urinary tract infection was 7.7%. For the presence of leukocyte esterase and a range of pyuria cut points, the positive likelihood ratios decreased with increasing specific gravity. From most dilute to most concentrated urine, the positive likelihood ratio decreased from 12.1 (95% confidence interval [CI] 10.7 to 13.7) to 4.2 (95% CI 3.0

2017 Annals of Emergency Medicine

10. Bladder Stimulation Technique for Clean Catch Urine Collection in Infants

the bladder stimulation technique. Three criteria are needed for each definition: Urinalysis result, number of organisms cultured and specific threshold for colony counts based on method of collection. Positive urinalysis: Bacteriuria, positive leukocyte esterase test, positive nitrite test and/or >/= 10 white blood cells per micro liter; negative urinalysis: do not meet criteria for positive urinalysis Secondary Outcome Measures : Time required for successful urine collection using the bladder (...) Bladder Stimulation Technique for Clean Catch Urine Collection in Infants Bladder Stimulation Technique for Clean Catch Urine Collection in Infants - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Bladder

2017 Clinical Trials

11. Accuracy of Automated Flow Cytometry-Based Leukocyte Counts To Rule Out Urinary Tract Infection in Febrile Children: a Prospective Cross-Sectional Study (PubMed)

% CI, 0.70 to 0.78]) and bacterial counts (0.89 [95% CI, 0.87 to 0.92]) (P < 0.001). Urinary WBC counts also had a significantly higher area under the ROC curve than that of the leukocyte esterase (LE) dipstick (0.92 [95% CI, 0.90 to 0.94]), nitrite dipstick (0.83 [95% CI, 0.80 to 0.87]), or the combination of positive LE and/or nitrite dipstick (0.91 [95% CI, 0.89 to 0.93]) test (P < 0.001). The presence of ≥35 WBC/μl of urine was the best cutoff point, yielding both a high sensitivity (99.5% [95 (...) Accuracy of Automated Flow Cytometry-Based Leukocyte Counts To Rule Out Urinary Tract Infection in Febrile Children: a Prospective Cross-Sectional Study Automated flow cytometry of urine remains an incompletely validated method to rule out urinary tract infection (UTI) in children. This cross-sectional analytical study was performed to compare the predictive values of flow cytometry and a dipstick test as initial diagnostic tests for UTI in febrile children and prospectively included 1,106

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2016 Journal of clinical microbiology

12. Urine Concentration and Pyuria for Identifying UTI in Infants. (PubMed)

system, stratified by urine concentration.Retrospective cross-sectional study of infants aged <3 months evaluated for UTI in the emergency department with paired urinalysis and urine culture. UTI was defined as ≥50 000 colony-forming units/mL from catheterized specimens. Test characteristics were calculated across a range of WBC and leukocyte esterase (LE) cut-points, dichotomized into specific gravity groups (dilute <1.015; concentrated ≥1.015).Twenty-seven thousand infants with a median age of 1.7 (...) Urine Concentration and Pyuria for Identifying UTI in Infants. Varying urine white blood cell (WBC) thresholds have been recommended for the presumptive diagnosis of urinary tract infection (UTI) among young infants. These thresholds have not been studied with newer automated urinalysis systems that analyze uncentrifuged urine that might be influenced by urine concentration. Our objective was to determine the optimal urine WBC threshold for UTI in young infants by using an automated urinalysis

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2016 Pediatrics

13. Urine culture guided antibiotic interventions: A pharmacist driven antimicrobial stewardship effort in the emergency department. (PubMed)

-pregnant and asymptomatic for urinary tract infection (UTI). 43% of 136 patients were treated with antibiotics, for a total of 426 antibiotic days. Pharmacist interventions for these patients resulted in 122/426 (29%) of potential antibiotic days saved. Factors found to significantly increase the odds of antibiotic prescribing in asymptomatic patients included presence of leukocyte esterase (OR=4.5, 95% CI: 1.2-17.2; p=0.03) or nitrites (OR=10.8, 95% CI: 1.7-68.1; p=0.01) in the urine and age≥75 (...) Urine culture guided antibiotic interventions: A pharmacist driven antimicrobial stewardship effort in the emergency department. Antibiotics are overprescribed for abnormal urine tests including asymptomatic bacteriuria (AB), contributing to rising antimicrobial resistance rates. Pharmacists reviewed urine cultures daily from emergency department (ED) encounters to assess antibiotic appropriateness. We studied antibiotic prescribing practices and assessed compliance to national guidelines

2016 American Journal of Emergency Medicine

14. Redefining Healthy Urine: A Cross-Sectional Exploratory Metagenomic Study of People With and Without Bladder Dysfunction. (PubMed)

with neuropathic bladder. Urine was originally collected by the usual method of bladder drainage and analyzed by urinalysis, culture and pyrosequencing. Urinalysis and culture values were stratified as leukocyte esterase (0, or 1 or greater), nitrite (positive or negative), pyuria (fewer than 5, or 5 or greater white blood cells per high power field), cloudy urine (positive or negative) and urine culture bacterial growth (less than 50,000, or 50,000 or greater cfu/ml). PathoScope was used for next generation (...) sequencing alignment, bacterial classification and microbial diversity characterization.Subjects with neuropathic bladder were significantly more likely to have positive leukocyte esterase and pyuria, cloudy urine and bacterial growth. Of 47 samples 23 showed bacterial growth on culture and in all samples bacteria were identified by pyrosequencing. Nonneuropathic bladder urine microbiomes included greater proportions of Lactobacillus crispatus in females and Staphylococcus haemolyticus in males

2016 Journal of Urology

15. Pyuria and Urine Cultures in Patients with Acute Renal Colic. (PubMed)

, and 14.2% of these patients had associated pyuria. There were 153 (45.1%) urine cultures performed, and 16 (10.5%) were positive. Patients with pyuria were more likely to have a positive urine culture (36.4% vs. 3.3%, respectively; p < 0.001). The percentage of positive urine cultures increased (p < 0.001) with increasing pyuria from 9.1% (10-20 WBC/HPF) to 60.0% (>50 WBC/HPF). Positive cultures also increased (p < 0.001) with increased leukocyte esterase observed on macroscopic samples, from 1.6 (...) % (small or less leukocyte esterase) to 77.8% (large-volume leukocyte esterase).Pyuria was found in 14.2% of patients with renal colic. Patients with pyuria had 36.4% positive cultures compared to 3.3% of patients without pyuria. The degree of pyuria or leukocyte esterase was significantly associated with the risk of a positive culture. Urine cultures are recommended for all patients with renal colic and pyuria.Copyright © 2016 Elsevier Inc. All rights reserved.

2016 Journal of Emergency Medicine

16. Treatment for Positive Urine Cultures in Hospitalized Adults: A Survey of Prevalence and Risk Factors in 3 Medical Centers. (PubMed)

given antibiotics for nonurinary indications, antibiotics were given to 38% (62/164) with ASB. Factors significantly associated with ASB treatment were elevated urine white cell count (65 vs 24 white blood cells per high-powered field, P<.01), hospital identity (hospital C vs A, odds ratio, 0.34 [95% CI, 0.14-0.80], P =.01), presence of leukocyte esterase (5.48 [2.35-12.79], P<.01), presence of nitrites (2.45 [1.11-5.41], P=.03), and Escherichia coli on culture (2.4 [1.2-4.7], P=.01). Of patients (...) Treatment for Positive Urine Cultures in Hospitalized Adults: A Survey of Prevalence and Risk Factors in 3 Medical Centers. Antibiotic treatment for asymptomatic bacteriuria (ASB) is prevalent but often contrary to published guidelines.To evaluate risk factors for treatment of ASB.Retrospective observational study.A tertiary academic hospital, county hospital, and community hospital.Hospitalized adults with bacteriuria.Patients without documented symptoms of urinary tract infection per

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2015 Infection control and hospital epidemiology

17. Automated Urinalysis and Urine Dipstick in the Emergency Evaluation of Young Febrile Children. (PubMed)

esterase, 0.94; and POC nitrite, 0.76. Sensitivities and specificities were 86% and 98% for automated leukocyte counts ≥ 100/μL and 98% and 98% for bacterial counts ≥ 250/μL. POC urine dipstick with ≥ 1+ leukocyte esterase or positive nitrite had a sensitivity of 95% and a specificity of 98%. Combinations of white blood cell and bacterial counts did not outperform bacterial counts alone.Automated leukocyte and bacterial counts performed well in the diagnosis of urinary tract infection in these febrile (...) months of age who underwent urethral catheterization to obtain POC and automated urinalyses and urine culture. Receiver operating characteristic analyses were performed and diagnostic indices were calculated for POC dipstick and automated cell counts at different cutpoints.Of 342 eligible children, 42 (12%) had urinary bacterial growth ≥ 50000/mL. The areas under the receiver operating characteristic curves were: automated white blood cell count, 0.97; automated bacterial count, 0.998; POC leukocyte

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2014 Pediatrics

18. A new highly sensitive point of care screen for spontaneous bacterial peritonitis using the leukocyte esterase method. (PubMed)

A new highly sensitive point of care screen for spontaneous bacterial peritonitis using the leukocyte esterase method. Urine reagent strips measuring leukocyte esterase activity have been studied to screen spontaneous bacterial peritonitis (SBP) but are insensitive. We calibrated a strip specifically for ascitic fluid to achieve high sensitivity in this diagnosis.Experiments were conducted on ascitic fluid from patients with cirrhosis. Samples with SBP were diluted with native acellular ascitic (...) fluid to achieve PMN counts below, above, and close to the diagnostic threshold of 250 PMN/microl. A model of SBP was created by spiking negative ascitic fluid samples (<250 PMN/microl) with activated PMN from blood of patients with sepsis, and diluted to achieve a range of PMN. Aliquots were tested at 2, 3, 4, and 10 min with the Periscreen leukocyte esterase strip. PMN/microl was correlated to timings and color scales: white defined negative (PMN <250/microl); and shades of brown, purple, and pink

2010 Journal of Hepatology

19. Reflect Urine Culture Cancellation in the Emergency Department. (PubMed)

criteria. Of these, 314 (20%) had positive urine cultures. Restriction of culture testing to samples with white blood cells > 10 per high-power field, positive nitrites, positive leukocyte esterase, or positive bacteria provided a sensitivity of 96.5% (95% confidence interval [CI] 93.6-98.1%) and specificity of 48.1% (95% CI 45.3-51.0%) for positive urine culture. Implementation of a reflex culture cancellation protocol based on these criteria would have eliminated 604 of 1546 cultures (39%); 11 of 314 (...) Reflect Urine Culture Cancellation in the Emergency Department. The yield of urine culture testing in the emergency department (ED) is often low, resulting in wasted laboratory and ED resources. Use of a reflex culture cancellation protocol, in which urine cultures are canceled when automated urinalysis results predict that culture yield will be low, may help to conserve these resources.To identify a reflex culture cancellation protocol consisting of urinalysis-based criteria to limit urine

2013 Journal of Emergency Medicine

20. Safety and Efficacy of Phenazopyridine Hydrochloride Tablets, USP 200 mg as an Analgesic for Short-Term Treatment in Female Subjects Suffering From Moderate-to-Severe Pain and Burning Upon Urination Associated With Uncomplicated Urinary Tract Infections (

for the study. Is a female 18 years of age or older. Has a clinical diagnosis of uncomplicated urinary tract infection (uUTI). Has a reported history indicating a diagnosis of cystitis or urethritis. Has a positive urine dipstick test showing the presence of nitrate or leukocyte esterase. Has moderate to severe pain (score of 4 to 10 inclusive on the NRS) and burning (score of 4-10, inclusive on the NRS) upon urination. Is willing and able to understand and comply with the requirements of the study. Each (...) Safety and Efficacy of Phenazopyridine Hydrochloride Tablets, USP 200 mg as an Analgesic for Short-Term Treatment in Female Subjects Suffering From Moderate-to-Severe Pain and Burning Upon Urination Associated With Uncomplicated Urinary Tract Infections ( Safety and Efficacy of Phenazopyridine Hydrochloride Tablets, USP 200 mg as an Analgesic for Short-Term Treatment in Female Subjects Suffering From Moderate-to-Severe Pain and Burning Upon Urination Associated With Uncomplicated Urinary Tract

2012 Clinical Trials

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