OnSite Adulteration Detection Devices Dipsticks for Urine Specimens

Standard urinalysis test strips such as Multistix from Bayer Diagnostics and Combur-Test from Roche Diagnostics are sometimes used to detect the presence of adulterants in urine. However, among various pads in the test strip, only pads for detection of nitrite, pH and specific gravity have some value. The specific gravity test does not differentiate between specific gravity of 1.000 and 1.005, and therefore, it is very difficult to apply it to identify substituted or diluted urine. The nitrite pad also detects a clinically significant range. Our experience indicates that a much deeper color develops with Multistix if nitrite is present in high concentrations as expected in an adulterated specimen. Moreover, some non-specific color change may be observed with the glucose test pad. More recently, on-site adulterant detection devices have become commercially available. These dipstick devices offer an advantage over spot tests because an adulteration check can also be performed at the collection site. Peace and Tarani evaluated the performance of three on-site devices, Intect 7 (Branan Medical Corporation), MASK Ultrascreen (Kacey Inc) and AdultaCheck 4 (Sciteck Diagnostics). Intect 7 can simultaneously test for creatinine, nitrite, glutaraldehyde, pH, specific gravity, PCC

and bleach. Ultrascreen tests for creatinine, nitrite, pH, specific gravity and oxidants. AdultaCheck 4 tests creatinine, nitrite, glutaraldehyde and pH. The authors adulterated urine specimens with Stealth, Urine Luck, Instant Clean ADD-IT-ive and Klear at their optimum usage concentration and concluded that Intect 7 was most sensitive and correctly identified adulterants. AdultaCheck 4 did not detect Stealth, Urine Luck or Instant Clean ADD-it-ive. Ultra Screen detected a broader range of adulterants than AdultaCheck 4. However in practice, it only detected these adulterants at levels well above their optimum usage, making it less effective than Intect 7 (47). King (48) reported that AdultaCheck 4 is an excellent way to detect contamination in urine specimen.

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