The uriscreen test to detect significant asymptomatic bacteriuria during pregnancy.
BACKGROUND
Asymptomatic bacteriuria (ASB) occurs in 2-11% of pregnancies and it is a clear predisposition to the development of acute pyelonephritis, which, in turn, poses risk to mother and fetus. Treatment of bacteriuria during pregnancy reduces the incidence of pyelonephritis. Therefore, it is recommended to screen for ASB at the first prenatal visit. The gold standard for detection of bacteriuria during pregnancy is urine culture, but this test is expensive, time-consuming, and labor-intensive.


OBJECTIVE
To determine the reliability of an enzymatic urine screening test (Uriscreen; Savyon Diagnostics, Ashdod, Israel) for detecting ASB in pregnancy.


METHODS
Catheterized urine samples were collected from 150 women who had routine prenatal screening for ASB. Patients with urinary symptoms, active vaginal bleeding, or who were previously on antibiotics therapy were excluded from the study. Sensitivity, specificity, and the positive and negative predictive values for the Uriscreen were estimated using urine culture as the criterion standard. Urine cultures were considered positive if they grew >10(5) colony-forming units of a single uropathogen.


RESULTS
Twenty-eight women (18.7%) had urine culture results indicating significant bacteriuria, and 17 of these 28 specimens had positive enzyme activity. Of 122 samples with no growth, 109 had negative enzyme activity. Sensitivity, specificity, and positive and negative predictive values for the Uriscreen test were 60.7% (+/-18.1), 89.3% (+/-5.6), 56.6%, and 90.8%, respectively.


CONCLUSIONS
The Uriscreen test had inadequate sensitivity for rapid screening of bacteriuria in pregnancy.
Teppa
Roberto J
RJ
Maternal-Fetal Unit, Department of Obstetrics and Gynecology, Dr. Domingo Luciani Hospital, Caracas, Venezuela.
Roberts
James M
JM
D000328:Adult; D001419:Bacteria / Q000302:isolation & purification*; D001681:Biological Assay / Q000379:methods; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D012016:Reference Values; D012680:Sensitivity and Specificity; D016482:Urinalysis / Q000379:methods*; D014546:Urinary Catheterization; D014552:Urinary Tract Infections / Q000175:diagnosis*