COMPARATIVE DIAGNOSTIC PERFORMANCE OF NITRITE AND LEUKOCYTE ESTERASE TESTS WITH URINE CULTURE FOR ASYMPTOMATIC BACTERIURIA SCREENING IN PREGNANCY

Background: Asymptomatic bacteriuria (ABU) during pregnancy is associated with many complications for both the fetus and the mother, including miscarriage, preterm labor, hypertension, pyelonephritis, renal failure, and even death. Early detection of urinary tract infection (UTI) using nitrite (N.) and leukocyte esterase (LE) dipstick testing can help reduce these complications. Objective: To evaluate the role of nitrite (N.) and leukocyte esterase (LE) dipstick tests compared to urine culture for the detection of ABU in pregnant women. Study Design: Prospective study. Setting: Department of Gynaecology & Obstetrics, Al-Yarmouk Teaching Hospital, over a period of one year from September 2023 to September 2024. Materials and Methods: A clean-catch midstream urine specimen was obtained from 500 pregnant women attending the antenatal clinic at Al-Yarmouk Teaching Hospital. One portion of the specimen was tested for nitrite (N.) and leukocyte esterase (LE.) activity using a dipstick. The second portion was plated on blood and MacConkey agars for culture, and the third portion was used for microscopical examination (ME). The results of the above-mentioned tests were compared. Results: ABU was prevalent in 12% (60/500) of the pregnant women evaluated. The nitrite (N.) test demonstrated 68.3% sensitivity (SN) and 100% specificity (SP), while the leukocyte esterase (LE) test showed 53.3% SN and 99.5% SP. Both were considered acceptable tests in comparison with urine culture. The predominant microorganism isolated was E. coli. Conclusion: The nitrite (N.) and leukocyte esterase (LE.) tests had high specificity and negative predictive value (NPV) compared to urine culture for the detection of ABU. However, the nitrite (N.) test was more sensitive and specific than the leukocyte esterase (LE.) test. In the current study, all cases that were positive on the nitrite test were also positive on urine culture, supporting its utility as a screening test for ABU.