Diagnostic performance of sexually transmitted infection screening in men with sterile leukocyturia detected by flow cytometry.

Authors

Itziar Angulo López, Leonora Hernández Ragpa, María Jesús Barberá Gracia, Mikel Urrutikoetxea Gutiérrez, Guillermo Quindós Andrés, José Luis Díaz de Tuesta Del Arco

Published in

Enfermedades infecciosas y microbiologia clinica (English ed.). Pages 503298. Oct 12, 2026. Epub Oct 12, 2026.

Abstract

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.
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.
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].
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.

PMID:
42864208
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.

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