Evaluation of Standard Wire Loop Method in Determination of Significant Bacteriuria among Pregnant Women in Ekpoma

Standard wire loop method is a time-tested method for UTI diagnosis. The term "bacteriuria" means the presence of bacteria in urine. It may result from contamination during or after collection of urine or it may indicate the presence of bacteria in the bladder urine. There are several cultural quantitative techniques for determining bacteriuria but standard wire loop method is the most popular method though relatively simple and cheap. This study was carried out to evaluate the standard wire loop method for determination of significant bacteriuria among pregnant women in Ekpoma. A total of one hundred (100) early morning mid-stream urine samples from pregnant women attending antenatal clinics in Ekpoma and environs were collected aseptically using sterile, wide-mouthed, leak-proof universal bottles. Microscopic examination was carried out to detect the presence of pus cells, epithelial cells, red blood cells, yeast cells, crystals, parasites, bacteria and casts. Undiluted urine, 1:10and 1:1000 diluted urine samples were aseptically inoculated into blood agar and MacConkey agar using the Standard Loop method and compared with Miles and Mirsa method, it was incubated at 370C aerobically for 24 hours. After incubation colonies were counted and isolates identified by standard biochemical methods. Colony count of ≥105 CFU per ml were considered as significant growth. In vitro antibiotics susceptibility of bacterial isolates was determined using disc diffusion technique. The data generated was analyzed statistically using the chi-squared statistics to ascertain the significance of the results. Out of 100 urine samples collected 39(39%) samples yielded significant bacterial growth, while 61(61%) of the samples had no significant bacterial growth or no growth with higher prevalence in age group <25 years which is a sexually active group than in other age group ≤35 years which had incidence rate of 12 (25%). Standard loop method gave false positive rates of 4/35 (11.4%) and false negative rates of 4/36 (11.1%). The standard loop was found to have a sensitivity of 100%, specificity of 88.9% and identical results in 76.3% of the samples. To reduce bacteriuria and consequently prevent UTIs, it is necessary to take the precautions by doing regular routine check-ups and appropriate treatment. For large scale urine surveys the method chosen should be reasonably accurate, fast and simple to use. The materials required should be minimal, stable and easily transported. It is recommended that the method of choice for most laboratories is the standard loop method.