Detection of Asymptomatic Bacteriuria by Nitrite and Leukocyte Easterase Tests versus Urine Culture during Pregnancy Miami Abdul Hassan Ali* FICOG, Shaimaa Sabri Athab** CABOG FICOG, Hala Ibrahim Salih** FICOG, Arij Sabah Abdulla** MBChB
Abstract
ABSTRACT Background: Asymptomatic bacteriuria is a major risk factor for the development of urinary tract infections during pregnancy and with further risk of preterm birth and pyelonephritis if untreated. There is good evidence that treatment of asymptomatic bacteriuria will decrease the incidence of pyelonephritis. So an early detection of urinary tract infection by nitrite and leukocyte easterase dipstick can decrease these complications.
Objective: To evaluate the efficacy of nitrite and leukocyte easterase versus the urine culture for detection of asymptomatic bacteriuria in pregnant women.
Methods: A prospective study conducted in Al-Yarmouk Teaching Hospital for a period of one year from September 2013 to September 2014. A clean catch midstream urine specimen obtained from 500 pregnant women present to antenatal clinic. One portion of specimen is test for nitrite and leukocyte easterase activity by dipstick, second portion of urine is plated on blood and MacConkey agars for culture. Comparison of the results of the above mentioned tests were done
Results: Asymptomatic bacteriuria was prevalent in 12% of 500 pregnant women who were evaluated in the current study. The current study revealed asymptomatic bacteriuria by nitrite with 68.3% sensitivity, 100% specificity and leukocyte easterase with 53.3% sensitivity, 99.5% specificity which were consider accepted tests in comparison with urine culture.
Conclusion: The nitrite test and leukocyte easterase tests had a high specificity (99.8) and negative predictive value (99.6) in comparison with urine culture for detection of asymptomatic bacteriuria. But nitrite test was more sensitive and specific than leukocyte easterase. In current study all positive cases of nitrite test were positive for urine culture, so it can be considered as a good test for detection of asymptomatic bacteriuria.
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