Evaluation of rapid urine screening tests to detect asymptomatic bacteriuria in pregnancy. 2006

Birgul Kacmaz, and Ozenc Cakir, and Altan Aksoy, and Aydan Biri
Department of Central Microbiolgy, Faculty of Medicine, Gazi University, Beşevler, Ankara, Turkey. kacmazbirgul@mynet.com

In order to compare the performance of leukocyte esterase and nitrite urine dipstick tests with enhanced urinalysis (uncentrifuged urine white blood cell count/mm(3) plus Gram stain) in detecting asymptomatic bacteriuria in obstetric patients, clean-catch midstream urine specimens were collected from 250 consecutive asymptomatic pregnant women. Ten of the women (4.0%) showed urine culture results indicating significant bacteriuria. The nitrite test was the most specific (99.2%) of these tests, however, its sensitivity was found to be the lowest (60.0%). The sensitivity of the leukocyte esterase test was 70.0%, on the other hand, while its positive predictive value was 28.0%. The sensitivity and specificity of enhanced urinalysis were found to be 50.0 and 96.7%, respectively. None of the rapid tests was found to be a reliable alternative for culture screening of all pregnant women. Nitrite tests are useful screening tests for detecting asymptomatic bacteriuria only if their limitations are fully understood, while leukocyte esterase and enhanced urinalysis tests are not suitable for screening for asymptomatic bacteriuria. Our findings support previous conclusions that quantitative urine cultures are required to rule out asymptomatic bacteriuria in pregnant women.

UI MeSH Term Description Entries
D009573 Nitrites Salts of nitrous acid or compounds containing the group NO2-. The inorganic nitrites of the type MNO2 (where M Nitrite
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011251 Pregnancy Complications, Infectious The co-occurrence of pregnancy and an INFECTION. The infection may precede or follow FERTILIZATION. Complications, Infectious Pregnancy,Infectious Pregnancy Complications,Maternal Sepsis,Pregnancy, Infectious Complications,Sepsis during Pregnancy,Sepsis in Pregnancy,Infectious Pregnancy Complication,Pregnancy Complication, Infectious,Sepsis in Pregnancies,Sepsis, Maternal
D011934 Reagent Strips Narrow pieces of material impregnated or covered with a substance used to produce a chemical reaction. The strips are used in detecting, measuring, producing, etc., other substances. (From Dorland, 28th ed) Reagent Strip,Strip, Reagent,Strips, Reagent
D002265 Carboxylic Ester Hydrolases Enzymes which catalyze the hydrolysis of carboxylic acid esters with the formation of an alcohol and a carboxylic acid anion. Carboxylesterases,Ester Hydrolases, Carboxylic,Hydrolases, Carboxylic Ester
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001437 Bacteriuria The presence of bacteria in the urine which is normally bacteria-free. These bacteria are from the URINARY TRACT and are not contaminants of the surrounding tissues. Bacteriuria can be symptomatic or asymptomatic. Significant bacteriuria is an indicator of urinary tract infection. Bacteriurias
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D016482 Urinalysis Examination of urine by chemical, physical, or microscopic means. Routine urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the sediment microscopically. Urinalyses

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