A 28 year-old woman presents with a 2-day history of urinary frequency, urgency and dysuria, stating, “This feels like when I had a urine infection 4 years ago.” She denies fever or GI upset and otherwise feels well.  In consideration of the diagnosis of lower UTI/cystitis, a urinalysis is ordered.  Which of the following is the most sensitive and specific finding for UTI caused by  a Gram-negative organism?

A. Positive leukocyte esterase

B. Presence of bacteriuria

C. Proteinuria

D. Positive nitrite

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