Ajayi A B, Nwabuisi C, Aboyeji P O, Fowotade A, Fakeye O O
Department of Obstetrics & Gynaecology, General Hospital Mushin, Ikeja, Lagos State, Nigeria.
West Afr J Med. 2010 Sep-Oct;29(5):339-43.
urinary tract infection is a common problem during pregnancy. Asymptomatic bacteriuria can cause the development of serious complications affecting both the mother and foetus. Urine culture, the traditional screening test is relatively expensive, time consuming and requires a microbiology laboratory and trained staff. However simpler, less expensive tests which include urine multistix and urine gramstain better suited for developing countries are available.
to determine the sensitivity, specificity and predictive values of multistix nitrite, leucocyte esterase (LE) and urine gram staining for asymptomatic bacteriuria in pregnancy.
A cross-sectional study was carried out from 1st July to 31st October 2007, at the University of Ilorin Teaching Hospital (UITH) on 125 consenting asymptomatic pregnant women. A structured proforma was used to collect information from the women and a midstream urine specimen collected in two sterile bottles. One was tested with Multistix® for the presence of nitrite and leucocyte esterase and the other for bacteriological culture and urine gram stain.
using the gold standard of urine culture, the sensitivities of Multistix® nitrite and leucocyte esterase were each 14% and the specificity 100% and 96% respectively. Urine gram stain had a sensitivity of 98% and a specificity of 74.7%.
multistix® nitrite and leucocyte esterase are not sufficiently sensitive to be used as a screening tool for asymptomatic bacteriuria. Urine gram stain can be used in areas where facilities are inadequate for culture but cannot replace it. More studies are required to determine the accuracy of urine gram-stain.
尿路感染是孕期常见问题。无症状菌尿可引发严重并发症，影响母亲和胎儿。传统的筛查试验——尿培养相对昂贵、耗时，且需要微生物实验室和经过培训的工作人员。然而，有更简单、成本更低的检测方法，包括尿液多项试纸条检测和尿革兰氏染色，更适合发展中国家。
确定尿液多项试纸条亚硝酸盐、白细胞酯酶（LE）及尿革兰氏染色对孕期无症状菌尿的敏感性、特异性和预测值。
2007年7月1日至10月31日，在伊洛林大学教学医院（UITH）对125名同意参与的无症状孕妇进行了一项横断面研究。使用结构化表格从这些女性中收集信息，并在两个无菌瓶中收集中段尿标本。一个用尿液多项试纸条检测亚硝酸盐和白细胞酯酶的存在情况，另一个用于细菌培养和尿革兰氏染色。
以尿培养作为金标准，尿液多项试纸条亚硝酸盐和白细胞酯酶的敏感性均为14%，特异性分别为100%和96%。尿革兰氏染色的敏感性为98%，特异性为74.7%。
尿液多项试纸条亚硝酸盐和白细胞酯酶作为无症状菌尿的筛查工具敏感性不足。尿革兰氏染色可用于培养设施不完善的地区，但不能替代尿培养。需要更多研究来确定尿革兰氏染色的准确性。
