Objective: To compare reagent strip testing (RST) with microscopy and culture in identifying significant bacteriuria, and secondly, to consider potential cost savings if RST screening proved to be reliable.
Design: Prospective descriptive study.
Setting: Antenatal Clinic, Bristol Maternity Hospital.
Subjects: Eight hundred and ninety-eight women having urine testing in pregnancy for microscopy and culture either routinely or because of a clinical infection.
Interventions: The midstream specimens of urine had RST examination using Ames Multistix 8SG prior to being sent to the laboratory.
Main outcome measure: Significant culture (> 10(5) colonies/ml) of a single organism in culture.
Results: The highest predictive value for a negative result of the urine culture (99.7%) was obtained when using four RSTs in combination. The RST for nitrite had a high predictive value for a positive urine culture (90%). The samples which gave a false negative result with RST screening were mainly infected with low grade urinary pathogens or genital tract contaminants.
Conclusion: RST screening for bacteriuria provides a reliable and cheap alternative to culture of all urine specimens.