A cross-sectional study on asymptomatic bacteriuria among antenatal women attending an urban tertiary health care center in Southern India

Abstract

Background: Asymptomatic bacteriuria (ASB) in pregnancy is a treatable risk factor for preterm delivery. India accounts for the highest preterm birth incidence in the world according to the WHO census released in November 2016. This study was aimed at finding the prevalence of asymptomatic bacteriuria, the spectrum of bacteria involved and the susceptibility pattern for the antimicrobials in the antenatal women attending a tertiary care hospital in urban Southern India.Methods: One hundred and eighty ante-natal patients without symptoms of ongoing urinary tract infection were enrolled to this study. Clean midstream urine sample was collected in a wide mouthed container and sample was analyzed by standardized microbiological testing techniques.Results: Out of the 180 ante-natal women included in the study, 11(6.1%) patients were found to have insignificant bacteriuria and 38(21.1%) had a significant bacteriuria. E. coli was the most frequently isolated organism and about 95% of the organisms were sensitive to Nitrofurantoin.Conclusions: More than a fifth of all pregnant women have ASB and E. coli is the most frequent pathogen encountered.

Prevalence of multidrug resistance (MDR) and extended spectrum beta-lactamases (ESBLs) among uropathogenic Escherichia coli isolates from female patients in a tertiary care hospital in North India

“…3,4 The present study revealed Escherichia coli as the predominant isolate from urine samples of female patients, which well correlates with many studies. [3][4][5][8][9][10][11][12] The age group wise distribution showed that Escherichia coli isolates were mostly prevalent in adult age group (21-40 years), which also correlates well with the studies conducted by Patnaik M et al, Oli A N et al and Arora G et al 2,4,13 The antibiotic sensitivity pattern of Escherichia coli in this study showed very good sensitivity towards Amikacin, Tigecycline, Meropenem, Fosfomycin, Imipenem, Ertapenem, Piperacillin-tazobactam, Nitrofurantoin, Gentamicin and Tobramycin, whereas showed moderate sensitivity towards Norfloxacin, Ciprofloxacin, Cefepime, Cefazolin, Ceftazidime, Ceftriaxone, Aztreonam and Trimethoprimsulfamethoxazole and showed low sensitivity towards Amoxycillin-clavulinic acid and Ampicillin.…”

“…UTI is a risk factor for pyelonephritis, preterm delivery and miscarriage among pregnant women. 4,5 Extended spectrum β-lactamases (ESBLs) are defined as β-lactamases capable of hydrolyzing oxyiminocephalosporins and are inhibited by β-lactamase inhibitors. The primary organism causing urinary tract infection (UTI) like Escherichia coli produce ESBLs.…”

<p>Prevalence of Asymptomatic Bacteriuria, Associated Factors and Antimicrobial Susceptibility Profile of Bacteria Among Pregnant Women Attending Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia</p>

“…9 Other factors that could predispose pregnant women to bacteriuria are age, lower socioeconomic status, multiparty, past history of UTI, history of catheterization, aminoaciduria, anemia, and diabetes mellitus. [10][11][12] In most cases, the leading cause of UTI is E. coli, 13 while other Gram-negative bacteria such as Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus species, and some Gram-positive bacteria are also responsible. 14 Significant numbers of pregnant women with ASB may develop acute upper UTI.…”

Maternofetal outcome in early versus late detected asymptomatic bacteriuria of pregnancy

“…Jain V et al and Paari P et al observed a higher prevalence of 16.9% and 21.1% respectively. 12,11 This can be explained by the variation in the population studied, their hygienic practices and socioeconomic status. Elzayat MA et al, in their study observed that ASB was significantly higher in the pregnant women who had sexual intercourse more than twice in a week and in the women who reported washing their genitals from back to front after defaecation.…”

“…Studies from the west have shown the prevalence of ASB to be in the range of 2-10%. 8,9 However several studies in India have shown the prevalence of ASB to be much higher in the range of 8-21.1 % [10][11][12][13] Moreover, studies show that screening and treatment of ASB reduces the risk of pyelonephritis in a population with moderate to high prevalence of bacteriuria. 14 Adam et al proposed that screening and treatment of ASB in pregnancy is the most cost effective intervention at the primary level of health care to achieve the millennium development goal for health.…”