Nitrite is not found in normal urine; gram negative bacteria reduce dietary nitrate to nitrites. If the bladder incubation time is insufficient, pathogens will not have time to produce this reaction.
A positive urinary nitrite test should always be followed by the collection of a mid-stream urine sample for microscopy, culture and sensitivity.
When combined with a leucocyte esterase test e.g. leucostix it has a 87% sensitivity and 67% specificity for urinary tract infections.
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