The uriscreen test to detect significant asymptomatic bacteriuria during pregnancy

Area of Science:

• Obstetrics and Gynecology
• Clinical Microbiology
• Diagnostic Testing

Background:

• Asymptomatic bacteriuria (ASB) affects 2-11% of pregnancies, increasing risks of acute pyelonephritis for mother and fetus.
• Treating ASB in pregnancy prevents pyelonephritis, necessitating reliable screening at the first prenatal visit.
• Urine culture, the gold standard for ASB detection, is costly and labor-intensive.

Purpose of the Study:

• To evaluate the diagnostic accuracy of the enzymatic Uriscreen test for detecting asymptomatic bacteriuria (ASB) in pregnant women.
• To compare the Uriscreen test's performance against standard urine culture for ASB diagnosis.

Main Methods:

• A study involving 150 pregnant women undergoing routine prenatal screening for ASB.
• Exclusion criteria included urinary symptoms, vaginal bleeding, or prior antibiotic use.
• Uriscreen performance was assessed by calculating sensitivity, specificity, and predictive values against urine culture results.

Main Results:

• The Uriscreen test demonstrated a sensitivity of 60.7% and specificity of 89.3% for detecting ASB.
• Positive and negative predictive values were 56.6% and 90.8%, respectively.
• Out of 150 samples, 28 showed significant bacteriuria by culture, with only 17 testing positive via Uriscreen.

Conclusions:

• The Uriscreen enzymatic test exhibits insufficient sensitivity for effective rapid screening of asymptomatic bacteriuria in pregnant individuals.
• The findings suggest that Uriscreen is not a reliable alternative to urine culture for ASB detection in this population.