Uriscreen, a rapid enzymatic urine screening test: useful predictor of significant bacteriuria in pregnancy.
OBJECTIVE
To establish the reliability of a new rapid enzymatic screening test, the Uriscreen, in the detection of significant bacteriuria in pregnancy.


METHODS
During a 6-month period, from July 1 to December 30, 1993, 313 consecutive pregnant patients were evaluated. Randomly voided, midstream, clean-catch urine specimens were used. Each sample was tested by routine laboratory culture and four rapid screening tests: the nitrite and leukocyte esterase dipstick, microscopic examination for pyuria, and the Uriscreen test. Results of the four rapid tests were compared with those of the urine culture.


RESULTS
Twenty-four women (7.6%) had urine culture results indicating significant bacteriuria. The sensitivity of the nitrite test, the leukocyte esterase test, and a microscopic examination for pyuria was low (37, 52, and 56%, respectively). The Uriscreen test showed very high sensitivity (100%), lower specificity (81%), a high predictive value of negative results (100%), and a low positive predictive value (30%).


CONCLUSIONS
The Uriscreen test is a reliable alternative to culture screening of all pregnant patients. A policy of performing a urine culture during pregnancy only on patients with a positive Uriscreen test will save as much as 80% of unnecessary cultures.
Hagay
Z
Z
Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynecology, Kaplan Hospital, Rehovot, Israel.
Levy
R
R
Miskin
A
A
Milman
D
D
Sharabi
H
H
Insler
V
V
D000328:Adult; D001437:Bacteriuria / Q000175:diagnosis* / Q000201:enzymology / Q000652:urine; D002265:Carboxylic Ester Hydrolases / Q000032:analysis*; D004796:Clinical Enzyme Tests; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000201:enzymology / Q000652:urine; D011446:Prospective Studies; D015203:Reproducibility of Results; D016482:Urinalysis
C021443:leukocyte esterase; D002265:Carboxylic Ester Hydrolases