Prevalence, detection and treatment of asymptomatic bacteriuria in a Turkish obstetric population.
OBJECTIVE
To prospectively determine the prevalence of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) and presenting symptoms of UTI as well as the most appropriate diagnostic test and success of single/combination drug treatment in a Turkish obstetric population.


METHODS
Between September and December 2000, 406 of 412 pregnant women admitted for an initial obstetric examination during the first trimester were evaluated. Results of clean-catch urine culture, microscopic urinalysis and dipstick urine tests were analyzed.


RESULTS
The prevalence of ASB (n = 43) and symptomatic UTI (n = 19) were 10.6% and 4.7%, respectively. The sensitivity and specificity of microscopic urinalysis were 71.0% and 73.6%, respectively. The sensitivity and specificity of dipstick testing were 38.7% and 35.8%, respectively. Eighty-three percent of ASB/UTI cases were effectively treated with a course of a single antimicrobial (amoxicillin or a first-generation cephalosporin).


CONCLUSIONS
If untreated, ASB can lead to acute, symptomatic UTI, including acute pyelonephritis, which in turn is associated with preterm labor and low birth weight. Therefore, screening for ASB early in pregnancy by methods with high sensitivity and treatment with appropriate antimicrobial regimens can decrease the risk of symptomatic UTI. In a Turkish clinical unit where culture is not available, the use of microscopic urinalysis was a clinically effective alternative method of detecting ASB. In this study, the sensitivity and specificity of dipstick testing were not high enough to recommend them as means of detecting ASB/UTI.
Kutlay
Sim
S
Department of Nephrology, Faculty of Medicine, Ankara University, Obstetric Outpatient Clinic and Microbiology Laboratory, Zübeyde Hanim Maternity Hospital, Ankara, Turkey.
Kutlay
Baran
B
Karaahmetoglu
Ozgur
O
Ak
Cetin
C
Erkaya
Salim
S
D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001437:Bacteriuria / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D002511:Cephalosporins / Q000627:therapeutic use; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D011261:Pregnancy Trimester, First; D015995:Prevalence; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014421:Turkey / Q000453:epidemiology; D014556:Urine / Q000382:microbiology
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D000658:Amoxicillin