Kacmaz Birgul, Cakir Ozenc, Aksoy Altan, Biri Aydan
Department of Central Microbiolgy, Faculty of Medicine, Gazi University, Beşevler, Ankara, Turkey.
Jpn J Infect Dis. 2006 Aug;59(4):261-3.
In order to compare the performance of leukocyte esterase and nitrite urine dipstick tests with enhanced urinalysis (uncentrifuged urine white blood cell count/mm(3) plus Gram stain) in detecting asymptomatic bacteriuria in obstetric patients, clean-catch midstream urine specimens were collected from 250 consecutive asymptomatic pregnant women. Ten of the women (4.0%) showed urine culture results indicating significant bacteriuria. The nitrite test was the most specific (99.2%) of these tests, however, its sensitivity was found to be the lowest (60.0%). The sensitivity of the leukocyte esterase test was 70.0%, on the other hand, while its positive predictive value was 28.0%. The sensitivity and specificity of enhanced urinalysis were found to be 50.0 and 96.7%, respectively. None of the rapid tests was found to be a reliable alternative for culture screening of all pregnant women. Nitrite tests are useful screening tests for detecting asymptomatic bacteriuria only if their limitations are fully understood, while leukocyte esterase and enhanced urinalysis tests are not suitable for screening for asymptomatic bacteriuria. Our findings support previous conclusions that quantitative urine cultures are required to rule out asymptomatic bacteriuria in pregnant women.
为了比较白细胞酯酶和亚硝酸盐尿试纸检测与强化尿液分析（未离心尿液白细胞计数/mm³加上革兰氏染色）在检测产科患者无症状菌尿方面的性能，从250名连续的无症状孕妇中收集了清洁中段尿标本。其中10名女性（4.0%）的尿培养结果显示有显著菌尿。在这些检测中，亚硝酸盐检测的特异性最高（99.2%），然而，其敏感性最低（60.0%）。另一方面，白细胞酯酶检测的敏感性为70.0%，而其阳性预测值为28.0%。强化尿液分析的敏感性和特异性分别为50.0%和96.7%。没有发现任何一种快速检测方法可作为所有孕妇培养筛查的可靠替代方法。只有充分了解亚硝酸盐检测的局限性，它才是检测无症状菌尿的有用筛查方法，而白细胞酯酶检测和强化尿液分析检测不适合用于筛查无症状菌尿。我们的研究结果支持先前的结论，即需要进行定量尿培养以排除孕妇无症状菌尿。
