APPLICATION OF A LEUKOCYTE AND NITRITE URINE TEST STRIP TO THE MANAGEMENT OF CHILDREN WITH NEUROGENIC BLADDER

A urine leukocyte count of greater-than-or-equal-to 50/mm3 together wi th a bacterial count of greater-than-or-equal-to 10(5) colony-forming units (CFUs) per milliliter was used to define significant infection i n 160 children with neurogenic bladder and evaluate the leukocyte and nitrite components of the Chemstrip 9 test. A Chemstrip 9 leukocyte re ading of less-than-or-equal-to 25 together with a negative nitrite rea ction occurred in 99 children and had a sensitivity of 83.5% and a neg ative predictive value for infection of 97.0%. A Chemstrip 9 reading o f greater-than-or-equal-to 500 leukocytes together with a positive nit rite reaction occurred in 18 children and had a sensitivity of 40% wit h a 100% positive predictive value for infection. Other combinations o f Chemstrip 9 leukocyte and nitrite reactions were unhelpful or of unc ertain value. Selection of up to three specimens from each patient inc reased the number of samples to 360 and provided general confirmation of the above conclusions. Nitrofurantoin may reduce the sensitivity of the nitrite strip reaction.