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The predictive value of inflammatory indices for urine culture positivity in pregnant women presenting with lower urinary tract symptoms
Ezgi Başaran1, Ülkü Gürbüz Özbebek2, ayse gulcin bastemur1, Atakan Tanacan1, Dilek şahin11Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara Bilkent City Hospital, Ankara, Türkiye2Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara Bilkent City Hospital, Ankara, Türkiye
INTRODUCTION: Urinary tract infection is one of the most common bacterial infections during pregnancy. However, not every pregnant woman presenting with lower urinary tract symptoms (LUTS) necessarily has an actual infection. Since urine culture, the gold standard for diagnosis, takes time to yield results, there is a need for rapid and practical
diagnostic tools. This study aims to evaluate the effectiveness of systemic inflammatory indices in predicting urine culture positivity.
METHODS: Pregnant women presenting with LUTS were retrospectively
evaluated. A total of 106 patients were included, with 53 positive and 53 negative urine cultures. Complete blood count parameters and C-reactive protein (CRP) levels at admission were analyzed. Inflammatory indices including the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), and aggregate systemic inflammation index (AISI)—were calculated and compared between the groups. Their predictive value for culture positivity was assessed.
RESULTS: Patients with positive cultures had significantly longer hospital stays (p = 0.015), higher rates of preterm birth (p = 0.020), and lower neonatal birth weight (p = 0.015). WBC, neutrophils, CRP, and all inflammatory indices were significantly higher in the culture-positive group (all p < 0.001). ROC analysis identified CRP as the most effective marker (AUC = 0.770; sensitivity: 76%, specificity: 70%), while SIRI was the most predictive inflammatory index (AUC = 0.742; sensitivity: 70%, specificity: 68%).
DISCUSSION AND CONCLUSION: Inflammatory indices are useful in predicting urine culture positivity in pregnant women with LUTS. The combined use of CRP and SIRI with WBC and neutrophil counts may enhance diagnostic efficiency.
Manuscript Language: English