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Urinary Tract Infection: A Risk Factor for False-Negative Urinary Ethyl Glucuronide but Not Ethyl Sulfate in the Detection of Recent Alcohol Consumption

Department of Clinical Neuroscience, Karolinska Institutet and University Hospital, Stockholm, Sweden;

^aaddress correspondence to this author at: Alcohol Laboratory, L7:03, Karolinska University Hospital Solna, SE-171 76 Stockholm, Sweden; fax 46-8-51771532, e-mail anders.helander@cns.ki.se

The first 300 words of the full text of this article appear below.

After consumption of alcoholic beverages, the bulk of the ethanol dose (95%–98%) is eliminated in a 2-stage oxidation process mainly in the liver, first to acetaldehyde by alcohol dehydrogenase and then further to acetic acid by aldehyde dehydrogenase. The remainder is excreted unchanged in urine, sweat, and expired air (1). In addition, a very small fraction (<0.1%) of the ingested ethanol undergoes phase II conjugation reactions to produce ethyl glucuronide (EtG) and ethyl sulfate (EtS) (2)(3), catalyzed by uridine diphosphate-glucuronosyltransferase or sulfotransferase, respectively. EtG and EtS are eventually excreted in the urine. As both of these nonoxidative direct ethanol metabolites show much longer elimination times than ethanol itself (3), the interest in EtG and EtS has focused largely on their use as sensitive and specific biomarkers of recent alcohol intake with clinical and forensic applications (4)(5). A positive finding of EtG and/or EtS provides a strong indication that the person was recently drinking alcohol, even when the ethanol concentration has returned to 0 or is no longer measurable.

Glucuronide and sulfate conjugates of endogenous and exogenous origin are cleaved by ß-glucuronidase and sulfatase, enzymes that are widely distributed among animals and plants. ß-Glucuronidase is also present with high activity in most strains of Escherichia coli (6). Because this characteristic is rather unique for E. coli compared with other bacterial species, ß-glucuronidase assays with chromogenic and fluorogenic substrates have been developed for the rapid and specific identification of E. coli in clinical microbiological diagnostics and for testing contamination of food and water (7)(8). Sulfatase activity has been detected in many different bacteria (9), but not in E. coli (10)(11), or only in very low amounts (12. . . [Full Text of this Article]

The following articles in journals at HighWire Press have cited this article:

				A. Helander, M. Bottcher, C. Fehr, N. Dahmen, and O. Beck Detection Times for Urinary Ethyl Glucuronide and Ethyl Sulfate in Heavy Drinkers during Alcohol Detoxification Alcohol Alcohol., January 1, 2009; 44(1): 55 - 61. [Abstract] [Full Text] [PDF]

				A. Helander, I. Olsson, and H. Dahl Postcollection Synthesis of Ethyl Glucuronide by Bacteria in Urine May Cause False Identification of Alcohol Consumption Clin. Chem., October 1, 2007; 53(10): 1855 - 1857. [Abstract] [Full Text] [PDF]

				A W Jones and L Karlsson Relation between bloodand urine-amphetamine concentrations in impaired drivers as influenced by urinary pH and creatinine Human and Experimental Toxicology, December 1, 2005; 24(12): 615 - 622. [Abstract] [PDF]

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