URISCREEN, A RAPID ENZYMATIC URINE SCREENING-TEST - USEFUL PREDICTOR OF SIGNIFICANT BACTERIURIA IN PREGNANCY

Objective: To establish the reliability of a new rapid enzymatic scree ning test, the Uriscreen, in the detection of significant bacteriuria in pregnancy. Methods: During a 6-month period, from July 1 to Decembe r 30, 1993, 313 consecutive pregnant patients were evaluated. Randomly voided, midstream, clean-catch urine specimens were used. Each sample was tested by routine laboratory culture and four rapid screening tes ts: the nitrite and leukocyte esterase dipstick, microscopic examinati on for pyuria, and the Uriscreen test. Results of the four rapid tests were compared with those of the urine culture. Results: Twenty-four w omen (7.6%) had urine culture results indicating significant bacteriur ia. The sensitivity of the nitrite test, the leukocyte esterase test, and a microscopic examination for pyuria was low (37, 52, and 56%, res pectively). The Uriscreen test showed very high sensitivity (100%), lo wer specificity (81%), a high predictive value of negative results (10 0%), and a low positive predictive value (30%). Conclusions: The Urisc reen testis a reliable alternative to culture screening of all pregnan t patients. A policy of performing a urine culture during pregnancy on ly on patients with a positive Uriscreen test will save as much as 80% of unnecessary cultures.