Exame simples de urina no diagnóstico de infecção urinária em gestantes de alto risco / Urine test to diagnose urinary tract infection in highh-risk pregant women
Rev. bras. ginecol. obstet
;
34(11): 488-493, nov. 2012. tab
Article
in Portuguese
| LILACS
| ID: lil-660886
RESUMO
OBJETIVO:
Identificar a acurácia do exame simples de urina para diagnóstico de infecção urinária em gestantes de alto risco.MÉTODOS:
Realizou-se um estudo transversal, prospectivo, em 164 gestantes admitidas na enfermaria de alto risco do Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), no período de janeiro a junho de 2011. Foram excluídas as pacientes em uso de antibiótico nos últimos dez dias. Todas as pacientes foram submetidas aos exames de urina simples e urocultura no início de sua admissão. A concordância entre os resultados dos exames foi avaliada pelo índice Kappa (K), sendo, ainda, determinados a acurácia, sensibilidade, especificidade e valor preditivo positivo (VPP) e negativo (VPN).RESULTADOS:
Utilizando como critério de diagnóstico apenas a presença de piócitos no exame simples de urina para sugerir bacteriúria, observou-se uma fraca concordância quando comparado à urocultura (K=0,16). A acurácia foi de 61%, com sensibilidade de 62,5% e especificidade de 60,6%. O VPP foi de 27,78% e o VPN, de 87%.CONCLUSÃO:
Na presença de alteração do exame simples de urina não necessariamente está em curso uma infecção urinária, sendo necessária a realização da urocultura. Porém, quando o exame simples de urina for normal, a urocultura pode ser dispensada.ABSTRACT
PURPOSE:
To identify the accuracy of urinalysis in the diagnosis of urinary tract infection in pregnant women at high risk.METHODS:
a prospective, cross-sectional study was conducted on 164 pregnant women admitted to the high-risk the ward of the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) during the period from January to June 2011. Patients who had been taking antibiotics in the last ten days were excluded. All patients were subjected to simple urine tests and urine culture at the beginning of their admission. The agreement between the results of the examinations was evaluated by Kappa indices (K), and accuracy, sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values were also determined.RESULTS:
When only the presence of pus cells in urinalysis was used as a diagnostic criterion suggesting bacteriuria, there was a poor agreement when compared to uroculture (K=0.16). Accuracy was 61%, sensitivity 62.5%, and specificity 60.6%. PPV was 27.78% and NPV was 87%.CONCLUSION:
The presence of alteration of urinalysis does not necessarily indicate an ongoing urinary tract infection, with urine culture being necessary. However, when urinalysis data are normal, uroculture may be avoided.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Pregnancy Complications, Infectious
/
Urinary Tract Infections
Type of study:
Diagnostic study
/
Etiology study
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Pregnancy
Language:
Portuguese
Journal:
Rev. bras. ginecol. obstet
Journal subject:
Gynecology
/
Obstetrics
Year:
2012
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Instituto de Medicina Integral/BR
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