ABSTRACT
A new reagent strip for the determination of leukocytes in urine (LEUKOSTIX; Ames) is described. The test is based on the esterase activity in leukocytes as a marker. Upon contact between the reagent matrix and a urine containing leukocytes, an amino acid ester is hydrolyzed by the esterase to its corresponding alcohol. The free alcohol then couples with a diazonium salt to produce a purple azo dye. The relative concentration of leukocytes in the urine is obtained by visually comparing the strip reaction with a color chart. Performance of the strip was evaluated in a clinical study involving eight different sites and 867 urine specimens. The comparison method was sediment microscopy; specimens containing five cells or more per high-power field were considered to be positive. Sensitivity was 76.3%, specificity 80.8%. Performance was comparable with that of the CHEMSTRIP LN (Boehringer-Mannheim Diagnostics, Inc.) leukocyte test, which we evaluated concurrently.
Subject(s)
Leukocytes/pathology , Reagent Strips/standards , Urologic Diseases/urine , Albuminuria/urine , Anti-Bacterial Agents/urine , Carbohydrates/urine , Esterases/analysis , Humans , Kinetics , Leukocyte Count , Leukocytes/enzymology , Quality Control , Time FactorsABSTRACT
The control system described here is used to monitor the performance of urinary reagent-strip tests for leukocytes. The presence of leukocyte esterase in the urine is used as a marker for leukocytes in urine. The control system is based on sonicated leukocytes, isolated from whole blood. The esterase activity of this sonicate is determined by spectrophotometry with the N-tosyl-L-alanine ester of 5-phenyl-3-hydroxypyrrole as substrate. The assay result is used to determine the amount of sonicate needed to prepare buffered esterase-containing solutions. Such control solutions mimic leukocytic urines and are stable for 6 h at room temperature. The variability of the control system was tested by preparing it five times in a day on five separate days. The overall CV for Leukostix Reagent Strips (Ames Division, Miles Laboratories, Inc.) when tested with these solutions and analyzed with a reflectance spectrophotometer was 8%; for visual readings it was 10%. The overall CV for Chemstrip LN Reagent Strips (Biodynamics, Indianapolis, IN) was 10%.
