Skip to main content

Advertisement

SpringerLink
Log in

The Uriscreen Test to Detect Significant Asymptomatic Bacteriuria During Pregnancy

  • Published:
The Journal of the Society for Gynecologic Investigation: JSGI Aims and scope Submit manuscript

Abstract

Background

Asymptomatic bacteriuria (ASB) occurs in 2-11% of pregnancies and it is a clear predisposition to the development of acute pyelonephritis, which, in turn, poses risk to mother and fetus. Treatment of bacteriuria during pregnancy reduces the incidence of pyelonephritis. Therefore, it is recommended to screen for ASB at the first prenatal visit. The gold standard for detection of bacteriuria during pregnancy is urine culture, but this test is expensive, time-consuming, and labor-intensive.

Objective

To determine the reliability of an enzymatic urine screening test (Uriscreen; Savyon Diagnostics, Ashdod, Israel) for detecting ASB in pregnancy.

Methods

Catheterized urine samples were collected from 150 women who had routine prenatal screening for ASB. Patients with urinary symptoms, active vaginal bleeding, or who were previously on antibiotics therapy were excluded from the study. Sensitivity, specificity, and the positive and negative predictive values for the Uriscreen were estimated using urine culture as the criterion standard. Urine cultures were considered positive if they grew >105 colony-forming units of a single uropathogen.

Results

Twenty-eight women (18.7%) had urine culture results indicating significant bacteriuria, and 17 of these 28 specimens had positive enzyme activity. Of 122 samples with no growth, 109 had negative enzyme activity. Sensitivity, specificity, and positive and negative predictive values for the Uriscreen test were 60.7% (±18.1), 89.3% (±5.6), 56.6%o, and 90.8%, respectively.

Conclusion

The Uriscreen test had inadequate sensitivity for rapid screening of bacteriuria in pregnancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. McNeeley SG. Treatment of urinary tract infections during pregnancy. Clin Obstet Gynecol 1988;31:480–8.

    Article  Google Scholar 

  2. Kass EH, Finland M. Asymptomatic infections of the urinary tract. Trans Assoc Am Phys 1956;69:56–63.

    CAS  PubMed  Google Scholar 

  3. Stamm WE, Wagner KF, Amsel R, Alexander ER, Turck M, Counts GW, Holmes KK. Causes of the acute urethral syndrome in women. N Engl J Med 1980;303:409–15.

    Article  CAS  Google Scholar 

  4. Harwood-Nuss A, Etheredge W, McKenna L. Urological emergencies. In: Barkin RM, ed. Emergency Medicine Concepts and Clinical Practice. St. Louis, MO: Mosby;1998:2227–61.

    Google Scholar 

  5. Kass EH. Bacteriuria and the diagnosis of infection of the urinary tract. Arch Intern Med 1957;100:709–14.

    Article  CAS  Google Scholar 

  6. Kass EH. Bacteriuria and pyelonephritis of pregnancy. Arch Intern Med 1960;105:194–8.

    Article  CAS  Google Scholar 

  7. Kass EH. Pyelonephritis and bacteriuria: A major problem in preventive medicine. Ann Intern Med 1962;56:46–53.

    Article  CAS  Google Scholar 

  8. Sobel JD, Kaye D. Host factors in the pathogenesis of urinary tract infections. Am J Med 1984;76:122–30.

    Article  CAS  Google Scholar 

  9. Stamey TA. The role of introital colonization in recurrent urinary infections. J Urol 1973;109:467–72.

    Article  CAS  Google Scholar 

  10. Hinman F Jr. Bacterial elimination. J Urol 1968;99:811–25.

    Article  Google Scholar 

  11. Andrews W, Cox S, Gilstrap LC. Urinary tract infections in pregnancy. Int Urogynecol J 1990;1:155–63.

    Article  Google Scholar 

  12. Bail JC, Witter FR. Sickle trait and its association with birth-weight and urinary tract infections in pregnancy. Int J Gynecol Obstet 1990;33:19–21.

    Article  Google Scholar 

  13. Little PJ. The incidence of urinary infection in 5000 pregnant women. Lancet 1966;2:925–8.

    Article  CAS  Google Scholar 

  14. Lye WC, Chan RK, Lee EJ. Urinary tract infections in patients with diabetes mellitus. J Infect 1992;24:169–74.

    Article  CAS  Google Scholar 

  15. Golan A, Wexler S, Amit A. Asymptomatic bacteriuria in normal and high risk pregnancy. Eur J Obstet Gynecol Reprod Biol 1989;33:101–8.

    Article  CAS  Google Scholar 

  16. Gaymans R, Haverkorn MI, Valkenburg HA, Goslings WRO. A prospective study of urinary tract infection in a Dutch general practice. Lancet 1976;308:674–7.

    Article  Google Scholar 

  17. Sussman M, Asscher AW, Waters WE, Evans JA, Campbell H, Evans KT, Williams JE. Asymptomatic significant bacteriuria in the non-pregnant woman: I. Description of a population. BMJ 1969;1:799–803.

    Article  CAS  Google Scholar 

  18. Sweet RL. Bacteriuria and pyelonephritis during pregnancy. Semin Perinatol 1977;1:25–40.

    CAS  PubMed  Google Scholar 

  19. Brumfelt W. The effects of bacteriuria in pregnancy on maternal and fetal health. Kidney Int 1975;8(suppl):113.

    Google Scholar 

  20. Gilstrap LC, Leveno KJ, Cunningham FG. Renal infection and pregnancy outcome. Am J Obstet Gynecol 1981;141:709–16.

    Article  CAS  Google Scholar 

  21. Romero R, Oyarzun E, Mazor M, Sirtori M, Hobbins JC, Bracken M. Meta-analysis of the relationship between asymptomatic bacteriuria and preterm delivery/low birth weight. Obstet Gynecol 1989;73:576–82.

    CAS  PubMed  Google Scholar 

  22. Stuart KL, Cummins GT, Chin WA. Bacteriuria, prematurity, and hypertensive disorders of pregnancy. BMJ 1965;1:554–6.

    Article  CAS  Google Scholar 

  23. Kincaid-Smith P, Buller M. Bacteriuria in pregnancy. Lancet 1965;1:395–9.

    Article  CAS  Google Scholar 

  24. Campbell-Brown M, McFadyen IR, Seal DV, et al: Is screening for bacteriuria in pregnancy worth while? Br Med Clin Res Ed 1987;294:1579–82.

    Article  CAS  Google Scholar 

  25. Andriole VT, Patterson TF. Epidemiology, natural history, and management of urinary tract infections in pregnancy. Med Clin North Am 1991;75:359–73.

    Article  CAS  Google Scholar 

  26. Whalley P. Bacteriuria of pregnancy. Am J Obstet Gynecol 1967;97:723–38.

    Article  CAS  Google Scholar 

  27. Norden CW, Kass EH. Bacteriuria of pregnancy. A critical appraisal. Annu Rev Med 1968;19:431–70.

    Article  CAS  Google Scholar 

  28. Rouse DJ, Andrews WW, Goldenberg RL, Owen J. Screening and treatment of asymptomatic bacteriuria of pregnancy to prevent pyelonephritis: A cost-effectiveness and cost-benefit analysis. Obstet Gynecol 1995;86:119–23.

    Article  CAS  Google Scholar 

  29. Wadland WC, Plante DA. Screening for asymptomatic bacteriuria in pregnancy. A decision and cost analysis. J Fam Pract 1989;29:372–6.

    CAS  PubMed  Google Scholar 

  30. MacMillan MC, Grimes DA. The limited usefulness of urine and blood cultures in treating pyelonephritis in pregnancy. Obstet Gynecol 1991;78:745–48.

    CAS  PubMed  Google Scholar 

  31. Braude A, Pittsburgh H. Detection of urinary catalase by disk flotation. J Lab Clin Med 1961;57:490–4.

    CAS  Google Scholar 

  32. Braude A. Catalase activity of infected urine. J Clin Invest 1959;38:990.

  33. Uriscreen Instruction Manual. Test for Bacteriuria and Presence of Somatic Cells in Urine. Ashdod, Israel: Savyon Diagnostic LTD, 1997.

    Google Scholar 

  34. Hagay Z, Levy R, Miskin A. Uriscreen, a rapid enzymatic urine screening test: Useful predictor of significant bacteriuria in pregnancy. Obstet Gynecol 1996;87:410–13.

    Article  CAS  Google Scholar 

  35. Millar L, DeBuque L, Leialoha C. Rapid enzymatic urine screening test to detect bacteriuria in pregnancy. Obstet Gynecol 2000;95:601–4.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Maternal-Fetal Unit, Department of Obstetrics and Gynecology, Dr. Domingo Luciani Hospital, Caracas, Venezuela

    Roberto J. Teppa MD & James M. Roberts MD

  2. Magee-Women’s Research Institute and Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, 15213, USA, 204 Craft Ave., Room 620

    Roberto J. Teppa MD & James M. Roberts MD

Authors
  1. Roberto J. Teppa MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. James M. Roberts MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to James M. Roberts MD.

Additional information

Supported by personal funding.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Teppa, R.J., Roberts, J.M. The Uriscreen Test to Detect Significant Asymptomatic Bacteriuria During Pregnancy. Reprod. Sci. 12, 50–53 (2005). https://doi.org/10.1016/j.jsgi.2004.07.007

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1016/j.jsgi.2004.07.007

Key words

Search

Navigation