Evaluation of reagent strips in detecting asymptomatic bacteriuria in early pregnancy: prospective case series.
OBJECTIVE
To evaluate the performance of reagent test strips in screening pregnant women for asymptomatic bacteriuria at their first visit to an antenatal clinic.


METHODS
Prospective case series.


METHODS
Antenatal clinic of a large inner city maternity hospital.


METHODS
All women attending for their first antenatal clinic. Patients taking antibiotics for any reason and those with urinary tract symptoms were excluded.


METHODS
A midstream urine specimen was divided; half was sent for microscopy and formal bacteriological culture and the other half was tested with a commercial reagent strip test for the presence of blood, protein, nitrite, and leucocyte esterase.


METHODS
Sensitivity, specificity, and positive and negative predictive values of the reagent strips in diagnosing asymptomatic bacteriuria (defined as 10(5) colony forming units/ml urine).


RESULTS
Sensitivity was low, with a maximum of 33% when all four tests were used in combination. Specificity was high, with typical values of 99% or more. Positive predictive value reached a maximum of 69% and negative predictive value was typically 95% or more.


CONCLUSIONS
Urine reagent strips are not sufficiently sensitive to be of use in the screening for asymptomatic bacteriuria and therefore many patients would be missed. In view of the potentially serious sequelae of this condition in pregnant women we recommend that formal bacteriological investigation remain the investigation of choice in this group of patients.
Tincello
D G
DG
Department of Urogynaecology, Liverpool Women's Hospital.
Richmond
D H
DH
D001437:Bacteriuria / Q000175:diagnosis*; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011296:Prenatal Diagnosis / Q000379:methods / Q000592:standards; D011446:Prospective Studies; D011934:Reagent Strips / Q000592:standards; D012680:Sensitivity and Specificity
D011934:Reagent Strips