Urology Book

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Urine Nitrite

Aka: Urine Nitrite
  1. Mechanism
    1. Some Bacteria reduce nitrates to nitrites
    2. Nitrite production typically requires urine standing (in Bladder) for at least 4 hours
      1. Infants do not hold their urine, and do not typically demonstrate nitrite on the urine sample
  2. Efficacy
    1. Test Specificity: >91%
    2. Test Sensitivity: <49%
  3. Interpretation
    1. Normal: Negative
    2. Positive
      1. Urinary Tract Infection
      2. Gross Hematuria
  4. Causes: False positive nitrite on Urinalysis
    1. Vaginal contaminant
    2. Phenazopyridine
    3. Dipstick exposed to air
      1. Close test strip containers immediately
      2. Strip exposed to air for 1 week: 33% false positive
      3. Strip exposed to air for 2 weeks: 75% false positive
  5. Causes: False negative nitrite on Urinalysis
    1. Increased Urine Specific Gravity
    2. Increased Urobilinogen
    3. Bacteria lacking nitrate reductase enzyme
    4. Urine pH <6.0
    5. Vitamin C supplementation
    6. Low nitrate diet

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