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Urinary interleukin-8 with asymptomatic bacteriuria in pregnancy
S D Shelton1, K A Boggess, K Kirvan
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Durham, North Carolina, USA. stuart.shelton@amedd.army.mil
Obstetrics and Gynecology
|March 29, 2001
Summary
Urinary interleukin-8 (IL-8) is not a reliable screening tool for asymptomatic bacteriuria in pregnant women, missing 30% of cases. Standard urine dipstick tests also showed limited accuracy in detecting this common pregnancy complication.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Clinical Chemistry
Background:
- Asymptomatic bacteriuria in pregnancy is a common condition associated with adverse maternal and fetal outcomes.
- Early detection and treatment are crucial to prevent complications such as pyelonephritis and preterm birth.
- Current screening methods, including urine dipstick tests, have limitations in sensitivity and specificity.
Purpose of the Study:
- To evaluate the efficacy of urinary interleukin-8 (IL-8) as a non-invasive biomarker for screening asymptomatic bacteriuria in pregnant women.
- To compare the diagnostic performance of urinary IL-8 with conventional urine dipstick analysis for detecting asymptomatic bacteriuria.
Main Methods:
- A prospective study involving 200 pregnant women screened for asymptomatic bacteriuria.
- Urine samples were analyzed using urine culture, urine dipstick (nitrite and leukocyte esterase), and urinary IL-8 measurement via chemiluminescent immunoassay.
- Receiver operating characteristic (ROC) curve analysis was employed to determine the optimal cutoff for IL-8 and compare its performance with dipstick testing.
Main Results:
- Twenty women (10%) were diagnosed with asymptomatic bacteriuria via urine culture.
- Median urinary IL-8 levels were significantly higher in women with bacteriuria (356 pg/mL) compared to those without (125 pg/mL; P <.01).
- At an optimal cutoff of 264 pg/mL, urinary IL-8 demonstrated a sensitivity of 70% and specificity of 67%, with a positive predictive value of 19% and negative predictive value of 95%.
Conclusions:
- Urinary IL-8 is not a suitable screening method for asymptomatic bacteriuria in pregnancy due to its insufficient sensitivity (failing to detect 30% of cases).
- The diagnostic performance of urinary IL-8 was comparable to, but not superior to, standard urine dipstick analysis in this cohort.
- Further research may be needed to explore alternative or adjunctive biomarkers for improved screening of asymptomatic bacteriuria in pregnant populations.