Enfermedades infecciosas y microbiologia clinica (English ed.) · 2026
Diagnostic performance of sexually transmitted infection screening in men with sterile leukocyturia detected by flow cytometry.
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Angulo López Itziar, Hernández Ragpa Leonora, Barberá Gracia María Jesús, Urrutikoetxea Gutiérrez Mikel, Quindós Andrés Guillermo, Díaz de Tuesta Del Arco José Luis
Аннотация
INTRODUCTION: Sexually transmitted infections (STIs) have increased in recent years, especially amongst young men. However, genitourinary symptoms continue to be initially managed as a urinary tract infection. The aim of this study was to evaluate the diagnostic yield of STI screening in urine samples submitted for culture from men with sterile leukocyturia and to assess the discriminative ability of leukocyturia for detecting STIs.
METHODS: A prospective study (June 2019-May 2024) was conducted using midstream urine samples from men aged 15-59 years with leukocyturia ≥20 leukocytes/μL detected by flow cytometry (UF-1000i and UF-5000i, Sysmex®) and negative urine culture. STI detection was performed using multiplex PCR (Allplex™ STI Essential Assay, Seegene). Demographic variables and leukocyturia were analyzed.
RESULTS: A total of 495 samples were included, with STIs diagnosed in 201 (40.6%). Chlamydia trachomatis was the most frequently detected pathogen (59.7%). Diagnostic yield was similar in Primary Care and the Emergency Department (41.6% vs 37.6%). Patients with STIs were younger (29 vs. 35 years; p< 0.001) and more frequently of foreign origin (51.6% vs. 35.3%; p< 0.001). Leukocyturia was higher in STI-positive than STI-negative samples [median (IQR): 358 (110-959) vs. 85 (35-315) WBC/μL; p < 0.001], mainly due to Neisseria gonorrhoeae [median (IQR): 1264 (690-3526) WBC/μL].
CONCLUSIONS: Opportunistic STI screening in men with sterile leukocyturia showed a high diagnostic yield and supports the systematic inclusion of molecular STI testing in this population. However, the discriminative ability of leukocyturia was limited.
METHODS: A prospective study (June 2019-May 2024) was conducted using midstream urine samples from men aged 15-59 years with leukocyturia ≥20 leukocytes/μL detected by flow cytometry (UF-1000i and UF-5000i, Sysmex®) and negative urine culture. STI detection was performed using multiplex PCR (Allplex™ STI Essential Assay, Seegene). Demographic variables and leukocyturia were analyzed.
RESULTS: A total of 495 samples were included, with STIs diagnosed in 201 (40.6%). Chlamydia trachomatis was the most frequently detected pathogen (59.7%). Diagnostic yield was similar in Primary Care and the Emergency Department (41.6% vs 37.6%). Patients with STIs were younger (29 vs. 35 years; p< 0.001) and more frequently of foreign origin (51.6% vs. 35.3%; p< 0.001). Leukocyturia was higher in STI-positive than STI-negative samples [median (IQR): 358 (110-959) vs. 85 (35-315) WBC/μL; p < 0.001], mainly due to Neisseria gonorrhoeae [median (IQR): 1264 (690-3526) WBC/μL].
CONCLUSIONS: Opportunistic STI screening in men with sterile leukocyturia showed a high diagnostic yield and supports the systematic inclusion of molecular STI testing in this population. However, the discriminative ability of leukocyturia was limited.