Evaluation of Three Different Techniques Used for the Detection of Asymptomatic Bacteriuria/Pyuria in Gestational Diabetes Mellitus

Abstract

Objective: To compare sensitivity, specificity, positive predictive value and negative predictive values of three different techniques such as, urine culture, urinary heparin binding protein assay by ELISA and identification of pathogens by multiplex PCR in gestational diabetes mellitus (GDM). Study design: An observational study was conducted in 50 GDM patients. Urine samples were collected and cultured. Antibiotic sensitivity testing was performed by the modified disc diffusion method. Urine heparin binding protein (UHBP) was estimated in the sample by ELISA. DNA was extracted from urine samples and pathogens were identified by multiplex PCR. Results: Prevalence of asymptomatic bacteriuria (ASB) among GDM patients on basis of urine culture was found to be 6%. A significant association was noted between detection of organisms and multiplex PCR findings compared to urine culture (p <0.0001). Median (25% - 75%) value of UHBP levels in urine was noted to be 689 (625, - 863) pg/ml. A significant association was observed between UHBP levels and multiplex PCR findings(p,0.05). No significant association was found between UHBP levels and urine culture. Conclusion: Multiplex PCR was found to be more sensitive and specific compared to Urine culture and estimation of UHBP by ELISA in detecting asymptomatic bacteriuria/ Pyuria. Overall, multiplex PCR appears to have higher sensitivity compared to UHBP measurement and urine culture, making it a promising technique for detecting ASB. However, further research is needed to validate and compare these methods in diverse populations and clinical settings. Moreover, considering the cost, availability, and turnaround time of each technique is essential when choosing the most suitable method for ASB detection.

Keywords

• gestational diabetes
• urinary tract infection
• aymptomatic bacteriuria
• multiplex pcr