Reliability of the urine spot test in predicting urinary tract infections during pregnancy: a cross-sectional study

Year 2023, Volume: 5 Issue: 4, 85 - 91, 28.12.2023

Kübra Dilbaz , Elif Ece Öztürk Özen , Sinan Karadeniz

https://doi.org/10.46969/EZH.1402089

Cited By: 1

Abstract

Background: The aim of this study was to investigate whether there is a significant difference in positive uronalysis (Total UA) results and fertility in urine cultures during pregnancy.
Material and Methods: Our retrospective observational study included 177 patients who were admitted to our hospital between September 1, 2023 and November 1, 2023 and had a complete urinalysis performed. As a result of the total UA, patients with leukocytes/bacteria> 5, leukocyte esterase positive and nitrite positive were identified. Among the patients whose urine culture was detected according to the results of urinalysis, those whose urine culture was evaluated and those who were not were divided into two groups. The results of total UA and urine culture were compared. In addition, the weeks of gestation of patients with positive urinalysis results were recorded and it was investigated whether there was a correlation between the frequency of urinary tract infections (UTI) and pregnancy.
Results: A total of 177 patients who were followed up for pregnancy were included in the study. All patients had total UA results. When the total UA abnormalities were examined, it was found that the rate of those with a high leukocyte/bacteria ratio was 80.2%, the rate of those with positive leukocyte esterase was 61%, and the rate of those who were nitrite positive was 25.4%. According to the urine culture results, 54.8% of participants had no urine culture and 45.2% of participants had one. The rate of urine cultures was 77.5% without reproduction and 22.5% with reproduction. In addition, the mean gestational weeks of the patients was 25.96±11.57 weeks, the mean week of gestation according to ultrasound measurements was 26.02±11.64. and no significant association was found between weeks of gestation and the incidence of UTI.
Conclusion: In our study, no significant association was found between positive total UA results during pregnancy and urine culture reproduction. There is a need for comprehensive multicenter studies with a larger number of patients regarding the incidence of UTIs in relation to gestational age and other tests that can be used in the diagnosis of UTIs.

Keywords

urinary tract infection during pregnancy, complete urinalysis, urine culture

Gebelikte idrar yolu enfeksiyonu öngörüsünde spot idrar tetkikinin güvenilirliği: kesitsel bir çalışma

Abstract

Amaç: Bu çalışmada gebelikte tam idrar tetkiki (TİT) sonuç pozitifliği ile idrar kültüründe üreme açısından anlamlı farklılık olup olmadığının araştırılması amaçlanmıştır.
Gereç ve Yöntemler: Retrospektif gözlemsel çalışmamıza hastanemizde 1 Eylül 2023-1 Kasım 2023 tarihleri arasında başvuran tam idrar tetkiki görülmüş olan gebelik durumu nedeni ile takipli 177 hasta dâhil edilmiştir. Tam idrar tetkiki sonucunda lökosit/bakteri>5 olan, lökosit esteraz pozitif olan ve nitrit pozitif olan hastalar tespit edildi. İdrar tetkik sonucuna göre üreme tespit edilen hastalardan idrar kültürü değerlendirilen ve değerlendirilmeyen hastalar iki gruba ayrıldı. tam idrar tetkiki ve idrar kültür üreme sonuçları karşılaştırıldı. Ayrıca idrar tetkik sonuç pozitifliği olan hastaların gebelik haftaları kaydedildi ve idrar yolu enfeksiyonu (İYE) geçirme sıklığı ile gebelik arasındaki ilişki incelendi.
Bulgular: Çalışmaya gebelik nedeni ile takipli toplam 177 hasta dahil edildi. Hastaların tamamında TİT sonucu vardı. TİT anormalliği incelendiğinde, lökosit/bakteri oranı yüksek olanların oranı %80,2, lökosit esteraz pozitif olanların oranı %61 ve nitrit pozitif olanların oranı %25,4 olarak bulunmuştur. İdrar kültürü sonuçlarına göre, katılımcıların %54,8’inde idrar kültürü yapılmamış, %45,2’sinde ise yapılmıştır. Yapılan idrar kültürlerinde üreme olmayanların oranı %77,5, üreme olanların oranı ise %22,5 olarak belirlenmiştir. Hastaların son adet tarihi (SAT) ortalaması 25,96±11,57 hafta iken ultrason ölçümlerine göre gebelik haftası ortalaması 26,02±11,64 olarak saptanmıştır ve hastaların gebelik haftaları ile İYE geçirme sıklığı arasında anlamlı bir ilişki tespit edilmemiştir.
Sonuç: Çalışmamızda gebelikte TİT sonuç pozitifliği ile idrar kültüründe üreme açısından anlamlı bir ilişki bulunmamıştır. Gebelik haftasına göre İYE görülme sıklığı ve İYE tanısında kullanılabilecek diğer tetkikler ile ilgili çok merkezli ve daha çok hasta sayılı kapsamlı çalışmalara ihtiyaç vardır.

Keywords

gebelikte idrar yolu enfeksiyonu, tam idrar tetkiki, idrar kültürü

Ethical Statement

Bu araştırma için Etlik Zubeyde Hanım Kadın Sağlığı Eğitim ve Araştırma Hastanesi Girişimsel Olmayan Çalışmalar Etik Kurulundan onay alınmıştır (Karar no: 11/23.11.2023).

Supporting Institution

Yok

Thanks

Yok

References

• Smaill FM, Vazquez JC. Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Database Syst Rev 2019; 2019.
• Moore A, Doull M, Grad R, et al. Recommendations on screening for asymptomatic bacteriuria in pregnancy. CMAJ 2018;190(27):E823-E830
• Nicolle LE, Gupta K, Bradley SF, et al. Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America. Clin Infect Dis 2019; 68 (10):83-110.
• Patterson TF, Andriole VT. Detection, significance, and therapy of bacteriuria in pregnancy. Update in the managed health care era. Infect Dis Clin North Am 1997; 11(3):593-608.
• Kass EH. Bacteriuria and pyelonephritis of pregnancy. Arch Intern Med 1960; 105:194-198.
• Sweet RL. Bacteriuria and pyelonephritis during pregnancy. Semin Perinatol 1977; 1(1):25-40.
• Naeye RL. Causes of the excessive rates of perinatal mortality and prematurity in pregnancies complicated by maternal urinary-tract infections. N Engl J Med 1979; 300(15):819-823.
• Millar LK, Cox SM. Urinary tract infections complicating pregnancy. Infect Dis Clin North Am 1997; 11:13. Infect Dis Clin North Am 1997;11(1):13-26
• Delzell JE Jr, Lefevre ML. Urinary tract infections during pregnancy. Am Fam Physician 2000; 61(3):713-721.
• Millar LK, DeBuque L, Wing DA. Uterine contraction frequency during treatment of pyelonephritis in pregnancy and subsequent risk of preterm birth. J Perinat Med 2003; 31(1):41-46.
• 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(4):576-582.
• Lin K, Fajardo K, U.S. Preventive Services Task Force. Screening for asymptomatic bacteriuria in adults: evidence for the U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med 2008; 149(1):20-24.
• Lumbiganon P, Laopaiboon M, Thinkhamrop J. Screening and treating asymptomatic bacteriuria in pregnancy. Curr Opin Obstet Gynecol 2010; 22(2):95–99.
• Eigbefoh JO, Isabu P, Okpere E, Abebe J.. The diagnostic accuracy of the rapid dipstick test to predict asymptomatic urinary tract infection of pregnancy. J Obstet Gynaecol 2008;28(5):490–495.
• Mignini L, Carroli G, Abalos E, et al. Accuracy of diagnostic tests to detect asymptomatic bacteriuria during pregnancy. Obstet Gynecol 2009;113: 346–352.
• Pappas PG. Laboratory in the diagnosis and management of urinary tract infections. Med Clin North Am 1991; 75(2):313-325.
• Urinary Tract Infections in Pregnant Individuals. Obstet Gynecol 2023; 142:435-445.
• Shelton SD, Boggess KA, Kirvan K, Sedor F, Herbert WN. Urinary interleukin-8 with asymptomatic bacteriuria in pregnancy. Obstet Gynecol 2001;97(4):583–586.
• Nicolle LE, Bradley S, Colgan R, et al. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis 2005;40(5):643–654.
• U.S. Preventive Services Task Force. Screening for asymptomatic bacteriuria in adults: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2008;149(1):43-47.
• Glaser AP, Schaeffer AJ. Urinary Tract Infection and Bacteriuria in Pregnancy. Urol Clin North Am 2015;42(4):547-560.
• High KP, Bradley SF, Gravenstein S, et al. Clinical practice guideline for the evaluation of fever and infection in older adult residents of long-term care facilities: 2008 update by the Infectious Diseases Society of America. Clin Infect Dis 2009;48(2):149–171.
• Hooton TM. Clinical practice. Uncomplicated urinary tract infection. N Engl J Med 2012;366(11):1028–1037.
• Lammers RL, Gibson S, Kovacs D, Sears W, Strachan G. Comparison of test characteristics of urine dipstick and urinalysis at various test cutoff points. Ann Emerg Med 2001; 38:505-512
• Hitzeman N, Greer D, Carpio E. Office-Based Urinalysis: A Comprehensive Review. Am Fam Physician 2022;106(1):27-35.
• Sundvall PD, Gunnarsson RK. Evaluation of dipstick analysis among elderly residents to detect bacteriuria: a cross-sectional study in 32 nursing homes. BMC Geriatr 2009;9:32.