Abstract

Background: Urinary tract infection is common during pregnancy and may cause significant maternal and fetal complications. Although urine culture is the diagnostic reference standard, dipstick testing offers a rapid and inexpensive alternative. Aim of the study: This study aimed to determine the diagnostic accuracy of combined leukocyte esterase and nitrite dipstick testing for culture-confirmed UTI among symptomatic pregnant women. Methods: This cross-sectional descriptive study included 105 symptomatic pregnant women consecutively enrolled at Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh from January 2025 to December 2025. Clean-catch midstream urine samples were tested by dipstick for leukocyte esterase and nitrite and compared with urine culture (considered as gold standard test) as the reference standard. Data were analyzed using SPSS; diagnostic performance was assessed using sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy with 95% confidence intervals. Results: Among the 105 participants, 87.6% were younger than 25 years. The mean gravidity was 1.64 ± 0.85, while the mean gestational age was 24.67 ± 4.79 weeks. Culture-confirmed UTI was identified in 7 of 105 participants (6.7%), and Escherichia coli was isolated in all culture-positive cases. Combined leukocyte esterase and nitrite dipstick testing showed 85.7% sensitivity, 98.0% specificity, 75.0% positive predictive value, 99.0% negative predictive value, and 97.1% overall diagnostic accuracy. Conclusion: Combined leukocyte esterase and nitrite dipstick testing showed high diagnostic accuracy. They may serve as a rapid, low-cost screening tool for UTI in symptomatic pregnant women, although urine culture remains essential for confirmation.

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