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<strong>KCE</strong> reports vol. 6A Prenatale zorg 84 Study Ref Population Intervention Outcomes Results Comments Study type EL patients over Bacteriuria > 1000 PPV º 1 100. 66.6 16.2 100.0 7 years organisms/ml NPV 0 McNair et 4 528 women at Urine culture Sensitivity Sensitivity: 100% (95% CI 88 to 100) Centrifugation with TES 3 al., 2000 [345] first antenatal compared with Gram staining will visit or centrifugation with Specificity Specificity: 7.7% (95% CI 5.6 to 10.5) potentially detect all admission cases of ASB but with a with possible Gram stain PPV PPV: 7.3% (95% CI 5.3 to 10.1) poor specificity will preterm incorrectly label over labour US hospital NPV NPV: 100% (95% CI 88.5 to 100) 90% of women as having ASB Bachman et al., 1993 Shelton et al., 2001 4 [347] 4 [343] February 1998 to March 1999 1047 patients attending antenatal clinic US hospital 200 women with attending antenatal clinic 20 identified as having ASB by urine culture US hospital Urine culture compared with Gram staining Urinary interleukin-8 vs. urine culture Sensitivity Specificity Sensitivity Specificity PPV NPV Sensitivity 91.7% Specificity 89.2% Sensitivity: 70% ( 95% CI 46 to 88) Specificity: 67 %( 95% CI 59 to 74) PPV: 19% (95% CI 11 to 30) NPV: 95% (95% CI 90 to 98) Less than 10 % of cases of ASB will potentially be missed and a little over 10% of cases incorrectly labelled as having ASB Urinary interleukin-8 will potentially fail to detect 30% of women with asymptomatic bacteriuria TES 3 TES 3
<strong>KCE</strong> reports vol. 6A Prenatale zorg 85 Study Ref Population Intervention Outcomes Results Comments Study type EL Millar et al., 4 383 women 2000 [344] with attending antenatal clinic US hospital Bacteriuria defined as 104 Rapid enzymatic Sensitivity Sensitivity: 70% (95% CI 56.5 to 83.5) The rapid enzymatic TES 3 screening test screening test will (detection of catalase Specificity Specificity: 45% (95% CI 39.5 to 50.5) potentially fail to detect activity) vs. urine 30% of women with culture PPV PPV: 14% (95% CI 9.0 to 19) asymptomatic bacteriuria colonyforming units of a single NPV NPV: 92% (95% CI 88 to 96) Graninger et al., 1992 4 [351] pathogen 1000 women attending antenatal clinic in a German hospital Women with asymptomatic bacteriuria found on antenatal screening Bioluminescence assay Sensitivity Specificity Predictive accuracy Development of pyelonephritis Sensitivity: 93% Specificity: 78% Predictive accuracy: 99% Risk of preterm delivery or low birth weight babies: TES 3 Does universal screening for asymptomatic bacteriuria during pregnancy (and treatment of those found to be positive) result in improved outcomes compared with no screening? Study Ref Population Intervention Outcomes Results Comments Study type EL Smaill, 4 [351] Cochrane review, Antibiotic Effect of antibiotic Effect of antibiotic treatment on Study quality was SR 1a 2002 updated 2000 treatment vs. treatment on persistent persistent on persistent bacteriuria assessed placebo or no bacteriuria during during pregnancy: and found to be generally 14 RCTs treatment pregnancy Treatment group: 38/293 (13%) Control group: 225/300 (75%) poor Risk of preterm delivery Peto odds ratio: 0.07 (95% CI 0.05 Inadequate allocation or low birth weight babies to 0.10) concealment except in one study No blinding of observer
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NATIONALE RICHTLIJN PRENATALE ZORG:
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Nationale richtlijn prenatale zorg:
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KCE reports 1. Effectiviteit en kos
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