A study of various tests to detect asymptomatic urinary tract infections in an obstetric population

John W. Bachman, James M Naessens, James M. Naessens, Mark G. Timmerman

Research output: Contribution to journalArticle

95 Citations (Scopus)

Abstract

Objective. - To compare rapid screening techniques for detecting asymptomatic urinary tract infections (AUTIs) in pregnant women. Design. - Comparison of results of the screening tests of urinalysis, urine dipstick, and Gram's staining with the results of standard urine culture at an initial prenatal visit. In follow-up visits, urine dipstick testing was compared with urinalysis. Setting. - Departments of Family Medicine and Obstetrics and Gynecology, Mayo Clinic, Rochester, Minn. Patients. - Pregnant women (1047) from the local community were screened for AUTI on initial and follow-up visits. Methods. - Initial prenatal urine was tested by using urine dipstick testing, urinalysis, Gram's staining, and urine culture. At each follow-up visit, urine specimens were tested by using urine dipstick and urinalysis. Main Outcome Measures. - Sensitivity and specificity, incremental patient costs, and clinical outcomes were used to assess the effectiveness of the techniques. Results. - On initial visits, rapid screening tests for AUTI in pregnant women revealed the following: Gram's staining identified 22 of 24 patients with AUTI (sensitivity, 91.7%; specificity, 89.2%); urine dipstick, 12 of 24 (sensitivity, 50.0%; specificity, 96.9%); and urinalysis with presence of leukocytes, six of 24 (sensitivity, 25.0%; specificity, 99.0%). In follow-up visits, urine dipstick tests detected 19 infections and urinalysis, three (positive predictive value, 5% compared with 3%). Conclusions. - Urine dipstick testing for nitrites identified half of all patients with urinary tract infections and was superior to urinalysis on follow-up visits. Although Gram's staining is more expensive, it was more accurate for AUTI than urinalysis or urine dipstick test for nitrites. Urinalysis was never the test of choice because it was more expensive and detected fewer positive cultures. Leukocyte measurement correlated poorly with AUTI.

Original languageEnglish (US)
Pages (from-to)1971-1974
Number of pages4
JournalJournal of the American Medical Association
Volume270
Issue number16
StatePublished - 1993
Externally publishedYes

Fingerprint

Urinary Tract Infections
Obstetrics
Urinalysis
Urine
Population
Staining and Labeling
Pregnant Women
Nitrites
Leukocytes
Gynecology
Medicine
Outcome Assessment (Health Care)
Costs and Cost Analysis
Sensitivity and Specificity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A study of various tests to detect asymptomatic urinary tract infections in an obstetric population. / Bachman, John W.; Naessens, James M; Naessens, James M.; Timmerman, Mark G.

In: Journal of the American Medical Association, Vol. 270, No. 16, 1993, p. 1971-1974.

Research output: Contribution to journalArticle

Bachman, John W. ; Naessens, James M ; Naessens, James M. ; Timmerman, Mark G. / A study of various tests to detect asymptomatic urinary tract infections in an obstetric population. In: Journal of the American Medical Association. 1993 ; Vol. 270, No. 16. pp. 1971-1974.
@article{7f68722efe0845e4927b7762acf11bcd,
title = "A study of various tests to detect asymptomatic urinary tract infections in an obstetric population",
abstract = "Objective. - To compare rapid screening techniques for detecting asymptomatic urinary tract infections (AUTIs) in pregnant women. Design. - Comparison of results of the screening tests of urinalysis, urine dipstick, and Gram's staining with the results of standard urine culture at an initial prenatal visit. In follow-up visits, urine dipstick testing was compared with urinalysis. Setting. - Departments of Family Medicine and Obstetrics and Gynecology, Mayo Clinic, Rochester, Minn. Patients. - Pregnant women (1047) from the local community were screened for AUTI on initial and follow-up visits. Methods. - Initial prenatal urine was tested by using urine dipstick testing, urinalysis, Gram's staining, and urine culture. At each follow-up visit, urine specimens were tested by using urine dipstick and urinalysis. Main Outcome Measures. - Sensitivity and specificity, incremental patient costs, and clinical outcomes were used to assess the effectiveness of the techniques. Results. - On initial visits, rapid screening tests for AUTI in pregnant women revealed the following: Gram's staining identified 22 of 24 patients with AUTI (sensitivity, 91.7{\%}; specificity, 89.2{\%}); urine dipstick, 12 of 24 (sensitivity, 50.0{\%}; specificity, 96.9{\%}); and urinalysis with presence of leukocytes, six of 24 (sensitivity, 25.0{\%}; specificity, 99.0{\%}). In follow-up visits, urine dipstick tests detected 19 infections and urinalysis, three (positive predictive value, 5{\%} compared with 3{\%}). Conclusions. - Urine dipstick testing for nitrites identified half of all patients with urinary tract infections and was superior to urinalysis on follow-up visits. Although Gram's staining is more expensive, it was more accurate for AUTI than urinalysis or urine dipstick test for nitrites. Urinalysis was never the test of choice because it was more expensive and detected fewer positive cultures. Leukocyte measurement correlated poorly with AUTI.",
author = "Bachman, {John W.} and Naessens, {James M} and Naessens, {James M.} and Timmerman, {Mark G.}",
year = "1993",
language = "English (US)",
volume = "270",
pages = "1971--1974",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "16",

}

TY - JOUR

T1 - A study of various tests to detect asymptomatic urinary tract infections in an obstetric population

AU - Bachman, John W.

AU - Naessens, James M

AU - Naessens, James M.

AU - Timmerman, Mark G.

PY - 1993

Y1 - 1993

N2 - Objective. - To compare rapid screening techniques for detecting asymptomatic urinary tract infections (AUTIs) in pregnant women. Design. - Comparison of results of the screening tests of urinalysis, urine dipstick, and Gram's staining with the results of standard urine culture at an initial prenatal visit. In follow-up visits, urine dipstick testing was compared with urinalysis. Setting. - Departments of Family Medicine and Obstetrics and Gynecology, Mayo Clinic, Rochester, Minn. Patients. - Pregnant women (1047) from the local community were screened for AUTI on initial and follow-up visits. Methods. - Initial prenatal urine was tested by using urine dipstick testing, urinalysis, Gram's staining, and urine culture. At each follow-up visit, urine specimens were tested by using urine dipstick and urinalysis. Main Outcome Measures. - Sensitivity and specificity, incremental patient costs, and clinical outcomes were used to assess the effectiveness of the techniques. Results. - On initial visits, rapid screening tests for AUTI in pregnant women revealed the following: Gram's staining identified 22 of 24 patients with AUTI (sensitivity, 91.7%; specificity, 89.2%); urine dipstick, 12 of 24 (sensitivity, 50.0%; specificity, 96.9%); and urinalysis with presence of leukocytes, six of 24 (sensitivity, 25.0%; specificity, 99.0%). In follow-up visits, urine dipstick tests detected 19 infections and urinalysis, three (positive predictive value, 5% compared with 3%). Conclusions. - Urine dipstick testing for nitrites identified half of all patients with urinary tract infections and was superior to urinalysis on follow-up visits. Although Gram's staining is more expensive, it was more accurate for AUTI than urinalysis or urine dipstick test for nitrites. Urinalysis was never the test of choice because it was more expensive and detected fewer positive cultures. Leukocyte measurement correlated poorly with AUTI.

AB - Objective. - To compare rapid screening techniques for detecting asymptomatic urinary tract infections (AUTIs) in pregnant women. Design. - Comparison of results of the screening tests of urinalysis, urine dipstick, and Gram's staining with the results of standard urine culture at an initial prenatal visit. In follow-up visits, urine dipstick testing was compared with urinalysis. Setting. - Departments of Family Medicine and Obstetrics and Gynecology, Mayo Clinic, Rochester, Minn. Patients. - Pregnant women (1047) from the local community were screened for AUTI on initial and follow-up visits. Methods. - Initial prenatal urine was tested by using urine dipstick testing, urinalysis, Gram's staining, and urine culture. At each follow-up visit, urine specimens were tested by using urine dipstick and urinalysis. Main Outcome Measures. - Sensitivity and specificity, incremental patient costs, and clinical outcomes were used to assess the effectiveness of the techniques. Results. - On initial visits, rapid screening tests for AUTI in pregnant women revealed the following: Gram's staining identified 22 of 24 patients with AUTI (sensitivity, 91.7%; specificity, 89.2%); urine dipstick, 12 of 24 (sensitivity, 50.0%; specificity, 96.9%); and urinalysis with presence of leukocytes, six of 24 (sensitivity, 25.0%; specificity, 99.0%). In follow-up visits, urine dipstick tests detected 19 infections and urinalysis, three (positive predictive value, 5% compared with 3%). Conclusions. - Urine dipstick testing for nitrites identified half of all patients with urinary tract infections and was superior to urinalysis on follow-up visits. Although Gram's staining is more expensive, it was more accurate for AUTI than urinalysis or urine dipstick test for nitrites. Urinalysis was never the test of choice because it was more expensive and detected fewer positive cultures. Leukocyte measurement correlated poorly with AUTI.

UR - http://www.scopus.com/inward/record.url?scp=0027380759&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027380759&partnerID=8YFLogxK

M3 - Article

VL - 270

SP - 1971

EP - 1974

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0002-9955

IS - 16

ER -