Asymptomatic bacteriuria screening for developing countries using a modified water quality test kit.

Area of Science:

• Microbiology
• Public Health
• Medical Diagnostics

Background:

• Asymptomatic bacteriuria (ASB) affects 2-15% of pregnant women, increasing risks of pyelonephritis, preterm labor, and low birth weight.
• Routine ASB screening via urine culture is standard in developed nations but unavailable in resource-limited settings.
• Existing dipstick tests are ineffective for ASB detection in pregnant populations.

Purpose of the Study:

• To adapt and validate the Aquagenx water quality test kit for diagnosing ASB in pregnant women.
• To develop a cost-effective and accessible ASB screening protocol for low-resource countries.

Main Methods:

• The Aquagenx kit, designed for detecting E. coli and coliforms in water, was tested for compatibility with human urine.
• A specific ASB screening protocol using disposable inoculating loops and optimized dilution was developed.
• Artificial and clinical urine samples were tested to determine the protocol's false positive (FP) and false negative (FN) rates.

Main Results:

• The adapted Aquagenx protocol showed a 0% FP rate and a 0% FN rate for ASB caused by coliforms in clinical samples.
• For artificial E. coli samples, the protocol achieved a 5.6% FN rate for ASB+ and a 33% FP rate for ASB-.
• The system accurately detected causative agents responsible for 90.1% of ASB cases, though it had limitations with non-coliform agents.

Conclusions:

• The repurposed Aquagenx kit shows high accuracy for detecting the most common bacterial agents of ASB in urine.
• This technology offers a viable, low-cost screening tool for ASB in pregnant women in resource-limited settings.
• Implementing this screening method can help prevent adverse pregnancy and birth outcomes associated with untreated ASB.