Detection of Asymptomatic Bacteriuria by Nitrite and Leukocyte Easterase Tests versus Urine Culture during Pregnancy
Background: Asymptomatic bacteriuria is a major risk factor for the development of
urinary tract infections during pregnancy and with further risk of preterm birth and
pyelonephritis if untreated. There is good evidence that treatment of asymptomatic
bacteriuria will decrease the incidence of pyelonephritis. So an early detection of urinary
tract infection by nitrite and leukocyte easterase dipstick can decrease these
Objective: To evaluate the efficacy of nitrite and leukocyte easterase versus the urine
culture for detection of asymptomatic bacteriuria in pregnant women.
Methods: A prospective study conducted in Al-Yarmouk Teaching Hospital for a period of
one year from September 2013 to September 2014. A clean catch midstream urine
specimen obtained from 500 pregnant women present to antenatal clinic. One portion of
specimen is test for nitrite and leukocyte easterase activity by dipstick, second portion of
urine is plated on blood and MacConkey agars for culture. Comparison of the results of
the above mentioned tests were done.
Results: Asymptomatic bacteriuria was prevalent in 12% of 500 pregnant women who
were evaluated in the current study. The current study revealed asymptomatic bacteriuria
by nitrite with 68.3% sensitivity, 100% specificity and leukocyte easterase with 53.3%
sensitivity, 99.5% specificity which were consider accepted tests in comparison with urine
Conclusion: The nitrite test and leukocyte easterase tests had a high specificity (99.8)
and negative predictive value (99.6) in comparison with urine culture for detection of
asymptomatic bacteriuria. But nitrite test was more sensitive and specific than leukocyte
easterase. In current study all positive cases of nitrite test were positive for urine culture,
so it can be considered as a good test for detection of asymptomatic bacteriuria.
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