Performance characteristics of urine dipsticks stored in open containers

Dip and read urinalysis is a laboratory test commonly performed by emergency physicians. Although the manufacturer states that the capped vials containing the dipsticks must be closed immediately after removal of a strip, this recommendation may not be followed in a busy emergency department. In a simple, two-part, blinded, and controlled trial the authors found that the reagents for determining leukocyte esterase, pH, protein, glucose, ketones, urobilinogen, bilirubin, and blood showed good reproducibility when fresh dipsticks were compared with dipsticks exposed to room temperature and humidity for 1 to 15 days. In contrast to this, the nitrite portion of the exposed dipsticks showed a rapid and cumulative loss of specificity over time. By the end of a week of exposure, one third of the nitrite tests gave false-positive readings. At the end of a second week, nearly three quarters gave false-positive readings for a specificity of only 28%. It is concluded that the nitrite reagent, in contrast to the other eight reagents on the Chemstrip-9 dipstick (Biodynamics, indianapolis, IN), rapidly loses accuracy when stored in uncapped vials.