Urinary tract infection during pregnancy--dipstick urinalysis vs. culture and sensitivity

Although it is important not to ignore clinical symptoms suggestive of a urinary tract infection (UTI), especially in antenatal patients, samples which have no abnormalities detected on bedside urinalysis may not need to be sent to the laboratory for culture and sensitivity (C&S) testing. If leucocytes, blood and/or protein are found in the samples, then they may need to be sent to the laboratory for further assessment, but no treatment needs to be instigated before obtaining the culture and sensitivity result, unless indicated clinically. The presence of nitrites in the sample is, however, much more suggestive of a bacterial infection and samples must be sent to the laboratory. In these cases, treatment with antibiotics prior to results may be warranted. Of the 100 samples tested in this study, only two had positive cultures for bacterial infection (Escherichia coli) and these were the only samples which had been strongly positive for nitrites using the Nephrur6Labsticks. These bedside screening tests may be a useful and cost-effective way of reducing the numbers of mid-stream urine samples sent to the laboratory for further testing.