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The diagnostic accuracy of the rapid dipstick test to predict asymptomatic urinary tract infection of pregnancy.
J Obstet Gynaecol. 2008 Jul; 28(5):490-5.JO

Abstract

Untreated urinary tract infection can have devastating maternal and neonatal effects. Thus, routine screening for bacteriuria is advocated. This study was designed to evaluate the diagnostic accuracy of the rapid dipstick test to predict urinary tract infection in pregnancy with the gold standard of urine microscopy, culture and sensitivity acting as the control. The urine dipstick test uses the leucocyte esterase, nitrite and test for protein singly and in combination. The result of the dipstick was compared with the gold standard, urine microscopy, culture and sensitivity using confidence interval for proportions. The reliability and validity of the urine dipstick was also evaluated. Overall, the urine dipstick test has a poor correlation with urine culture (p = 0.125, CI 95%). The same holds true for individual components of the dipstick test. The overall sensitivity of the urine dipstick test was poor at 2.3%. Individual sensitivity of the various components varied between 9.1% for leucocyte esterase and the nitrite test to 56.8% for leucocyte esterase alone. The other components of the dipstick test, the test of nitrite, test for protein and combination of the test (leucocyte esterase, nitrite and proteinuria) appear to decrease the sensitivity of the leucocyte esterase test alone. The ability of the urine dipstick test to correctly rule out urinary tract infection (specificity) was high. The positive predictive value for the dipstick test was high, with the leucocyte esterase test having the highest positive predictive value compared with the other components of the dipstick test. The negative predictive value (NPV) was expectedly highest for the leucocyte esterase test alone with values higher than the other components of the urine dipstick test singly and in various combinations. Compared with the other parameters of the urine dipstick test, singly and in combination, leucocyte esterase appears to be the most accurate (90.25%). The dipstick test has a limited use in screening for asymptomatic bacteriuria. The leucocyte esterase test component of the dipstick test appears to have the highest reliability and validity. The other parameters of the dipstick test decreases the reliability and validity of the leucocyte esterase test. A positive test merits empirical antibiotics, while a negative test is an indication for urine culture. The urine dipstick test if positive will also be useful in follow-up of patient after treatment of urinary tract infection. This is useful in poor resource setting especially in the third world where there is a dearth of trained personnel and equipment for urine culture.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Irrua Specialist Teaching Hospital, Irrua, Nigeria. eigbefoh2003@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

18850421

Citation

Eigbefoh, J O., et al. "The Diagnostic Accuracy of the Rapid Dipstick Test to Predict Asymptomatic Urinary Tract Infection of Pregnancy." Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology, vol. 28, no. 5, 2008, pp. 490-5.
Eigbefoh JO, Isabu P, Okpere E, et al. The diagnostic accuracy of the rapid dipstick test to predict asymptomatic urinary tract infection of pregnancy. J Obstet Gynaecol. 2008;28(5):490-5.
Eigbefoh, J. O., Isabu, P., Okpere, E., & Abebe, J. (2008). The diagnostic accuracy of the rapid dipstick test to predict asymptomatic urinary tract infection of pregnancy. Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology, 28(5), 490-5. https://doi.org/10.1080/01443610802196914
Eigbefoh JO, et al. The Diagnostic Accuracy of the Rapid Dipstick Test to Predict Asymptomatic Urinary Tract Infection of Pregnancy. J Obstet Gynaecol. 2008;28(5):490-5. PubMed PMID: 18850421.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The diagnostic accuracy of the rapid dipstick test to predict asymptomatic urinary tract infection of pregnancy. AU - Eigbefoh,J O, AU - Isabu,P, AU - Okpere,E, AU - Abebe,J, PY - 2008/10/14/pubmed PY - 2009/3/27/medline PY - 2008/10/14/entrez SP - 490 EP - 5 JF - Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology JO - J Obstet Gynaecol VL - 28 IS - 5 N2 - Untreated urinary tract infection can have devastating maternal and neonatal effects. Thus, routine screening for bacteriuria is advocated. This study was designed to evaluate the diagnostic accuracy of the rapid dipstick test to predict urinary tract infection in pregnancy with the gold standard of urine microscopy, culture and sensitivity acting as the control. The urine dipstick test uses the leucocyte esterase, nitrite and test for protein singly and in combination. The result of the dipstick was compared with the gold standard, urine microscopy, culture and sensitivity using confidence interval for proportions. The reliability and validity of the urine dipstick was also evaluated. Overall, the urine dipstick test has a poor correlation with urine culture (p = 0.125, CI 95%). The same holds true for individual components of the dipstick test. The overall sensitivity of the urine dipstick test was poor at 2.3%. Individual sensitivity of the various components varied between 9.1% for leucocyte esterase and the nitrite test to 56.8% for leucocyte esterase alone. The other components of the dipstick test, the test of nitrite, test for protein and combination of the test (leucocyte esterase, nitrite and proteinuria) appear to decrease the sensitivity of the leucocyte esterase test alone. The ability of the urine dipstick test to correctly rule out urinary tract infection (specificity) was high. The positive predictive value for the dipstick test was high, with the leucocyte esterase test having the highest positive predictive value compared with the other components of the dipstick test. The negative predictive value (NPV) was expectedly highest for the leucocyte esterase test alone with values higher than the other components of the urine dipstick test singly and in various combinations. Compared with the other parameters of the urine dipstick test, singly and in combination, leucocyte esterase appears to be the most accurate (90.25%). The dipstick test has a limited use in screening for asymptomatic bacteriuria. The leucocyte esterase test component of the dipstick test appears to have the highest reliability and validity. The other parameters of the dipstick test decreases the reliability and validity of the leucocyte esterase test. A positive test merits empirical antibiotics, while a negative test is an indication for urine culture. The urine dipstick test if positive will also be useful in follow-up of patient after treatment of urinary tract infection. This is useful in poor resource setting especially in the third world where there is a dearth of trained personnel and equipment for urine culture. SN - 1364-6893 UR - https://www.unboundmedicine.com/medline/citation/18850421/The_diagnostic_accuracy_of_the_rapid_dipstick_test_to_predict_asymptomatic_urinary_tract_infection_of_pregnancy_ L2 - https://www.tandfonline.com/doi/full/10.1080/01443610802196914 DB - PRIME DP - Unbound Medicine ER -