***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The presence of group-B streptococci in the urine of pregnant women seems to be associated with preterm labour . Urine sample s from 4122 women at 27 - 31 weeks ' gestation were examined for bacteria . Group-B streptococci were found in the urine of 69 women . In a double-blind , controlled study these patients were given either penicillin ( 10(6 ) IU three times daily for 6 days ; 37 patients ) or placebo ( 32 patients ) . The rates of primary rupture of the membranes ( 11 % v 53 % ; p less than 0.001 ) and preterm labour ( 5.4 % v 38 % ; p less than 0.002 ) were significantly lower in the penicillin group than in the placebo group . These results suggest that treatment and follow-up to prevent recolonisation in pregnant women with group-B streptococci in the urine may reduce the frequency of preterm labour in these patients A total of 1,661 pregnant women aged between 13 and 45 years were screened for bacteriuria by urine culture . Of the 1,661 culture results , 615 ( 37 % ) yielded no growth ; 728 ( 43.8 % ) yielded no significant growth ( presence of < 10(5 ) organisms/ml urine of one or more types of bacteria ) ; 286 ( 17.2 % ) yielded mixed growth ( presence of > 10(5 ) organisms/ml urine of more than one type of bacteria ) and only 32 ( 1.9 % ) showed significant growth ( presence of > 10(5 ) organisms/ml urine of a single bacterium ) . Urine microscopy was also conducted . Two hundred and twenty-four ( 13.5 % ) specimens had > 10 white blood cells/ml urine , of which 66 had > 100 white blood cells ; 13 were from the significant growth group . Three hundred and seventy-four ( 22.5 % ) specimens showed the presence of bacteria , 42 ( 2.5 % ) had red blood cells , 370 ( 22.3 % ) had epithelial cells , 58 ( 3.5 % ) had crystals , and 14 ( 0.8 % ) had yeasts . The most common bacterium isolated was Escherichia coli ( 12 ; 40 % ) ; the others included group B Streptococcus ( 5 ; 15 % ) , Klebsiella spp ( 5 ; 15 % ) , Diphtheroids ( 2 ) , and C and ida albicans ( 2 ) . Fifty-two percent of tested strains were sensitive to  ampicillin ; 24 of 28 strains ( 85.7 % ) were sensitive to  ciprofloxacin ; all 7 strains tested were sensitive to nitrofurantoin and all 20 strains tested were sensitive to cotrimoxazole ; 14/20 ( 70 % ) and 16/17 ( 94.1 % ) were sensitive to cephalexin and cefuroxime respectively . This study shows that asymptomatic bacteriuria does occur in pregnant women , albeit at a very low rate in an urban setting like Cheras . Urine microscopy is not specific and only serves as a guide to bacteriuria . The commonest causative organisms are those from the gastrointestinal tract and vagina . The antibiogram showed that cefuroxime and cephalexin are likely to be effective in treating bacteriuria : ampicillin must be reserved for Gram-negative organisms . For Gram-positive organisms , of which Group B Streptococcus is important , ampicillin is still effective in vitro . Nitrofurantion and cotrimoxazole have excellent activity in vitro and should be considered for therapy . 17.2 % of the urine culture yielded mixed growth : likely to indicate that contamination of urine specimens still happens despite the strict instructions given to patients about the collection of a midstream urine specimen . Proper collection , appropriate transport , and the early processing of urine specimens remain essential Abstract Objective : To evaluate the performance of reagent test strips in screening pregnant women for asymptomatic bacteriuria at their first visit to an antenatal clinic . Design : Prospect i ve case series . Setting : Antenatal clinic of a large inner city maternity hospital . Subjects : All women attending for their first antenatal clinic . Patients taking antibiotics for any reason and those with urinary tract symptoms were excluded . Intervention : A midstream urine specimen was divided ; half was sent for microscopy and formal bacteriological culture and the other half was tested with a commercial reagent strip test for the presence of blood , protein , nitrite , and leucocyte esterase . Main outcome measures : Sensitivity , specificity , and positive and negative predictive values of the reagent strips in diagnosing asymptomatic bacteriuria ( defined as 105 colony forming units/ml urine ) . Results : Sensitivity was low , with a maximum of 33 % when all four tests were used in combination . Specificity was high , with typical values of 99 % or more . Positive predictive value reached a maximum of 69 % and negative predictive value was typically 95 % or more . Conclusion : Urine reagent strips are not sufficiently sensitive to be of use in the screening for asymptomatic bacteriuria and therefore many patients would be missed . In view of the potentially serious sequelae of this condition in pregnant women we recommend that formal bacteriological investigation remain the investigation of choice in this group of patients . Key messages Asymptomatic bacteriuria is a potentially serious clinical condition Early antenatal urine screening should identify all cases to ensure adequate treatment Commercially available reagent strips for testing urine do perform to a sufficient st and ard The cost savings associated with reagent strips can not be justified in this group of women All patients should have at least one urine specimen formally cultured in early pregnancy to exclude Pivmecillinam was given to 44 women with bacteriuria in pregnancy . Treatment was successful in 33 ( 87 % ) out of the 38 patients assessed . Thirty women subsequently received at r and om either a low-dose of pivmecillinam for up to three months or acted as a control group . Further bacteriuric episodes during pregnancy were recorded only in three patients in the control group . Thirty-nine out of the 41 women followed to term delivered healthy babies . One infant was stillborn and another child had a cleft palate . Neither was considered to be related to treatment with pivmecillinam The incidence of impaired renal concentrating ability in pregnant women with asymptomatic significant bacteriuria is significantly less than previously reported when osmolality readings are performed on every urine specimen obtained during the 24 hours ' deprivation of fluids . The concentrating defect is more considerable as pregnancy progresses . The lower the maximum urinary osmolality the more difficult is the treatment of the patient , and the higher the incidence of acute pyelonephritis Although it has been shown that  bacteriuria of pregnancy  can be eradicated by keeping patients on antibacterial agents throughout pregnancy [ 1 ] , this regimen of treatment would be unacceptable to most individuals , particularly when asymptomatic ; and there are many who would question the ethical justification for such prolonged antibacterial therapy in pregnancy . This paper presents the results of a study design ed to determine whether antibacterial therapy of limited duration would eradicate 
    Output:
    
REVIEW ER 'S CONCLUSIONS Antibiotic treatment is effective in reducing the risk of pyelonephritis in pregnancy .