Assessment of asymptomatic bacteriuria and sterile pyuria among antenatal attendants in hospitals in northern Ghana

Abstract

Background: Asymptomatic bacteriuria (ASB) and sterile pyuria (SP) are complexities of UTI whose prevalence are not known in the northern sector of Ghana. Our aim was to determine the occurrence of sterile pyuria and asymptomatic bacteriuria among pregnant women accessing antenatal care at a secondary and tertiary care hospitals in Tamale, northern Ghana. Methods: A cross sectional study was conducted by screening 530 pregnant women with no signs of acute urinary tract infection attending antenatal clinic for a period of 6 months. Midstream urine was collected for microscopy, quantitative urine culture and antibiotic susceptibility testing. Data analysis was carried out using the Statistical Package for Social Sciences version 20. Results: Asymptomatic bacteriuria was respectively 20 and 35.5% at Tamale Central and Tamale Teaching Hospital out of the 390 and 90 women screened. Sterile pyuria was found among 66% of the 50 women presenting at Tamale Central Hospital. More than 64% of isolates recovered from ASB patients were S. aureus and coagulase negative Staph. (CoNS). Escherichia coli was the dominant species among members of the enterobacteriaceae isolated. Highest susceptibility was recorded against gentamicin and amikacin while most resistance was to Ampicillin, cotrimoxazole, chloramphenicol and nitrofurantoin. Resistance to imipenem and vancomycin were 28.8 and 52%, with strains showing multiple drug resistance of between 81 and 92%. Conclusion: The prevalence of asymptomatic bacteriuria is appreciably higher (20-35.5%) than documented rates in the southern sector of the country. The presence of sterile pyuria which may be an indication of asymptomatic renal impairment and most often overlooked in antenatal management is 66%. Empirical treatment of UTIs at the Tamale Central and Teaching Hospital without confirmation of susceptibility may result in treatment failure. It is necessary to screen and treat pregnant women for ASB and SP due to the complications associated with these conditions.

Escherichia coli from urine samples of pregnant women as an indicator for antimicrobial resistance in the community: a field study from rural Burkina Faso

“…The ASB proportion in the present study was lower compared to some earlier studies from sub-Saharan Africa, citing proportions of 7–40% [ 17 , 22 – 24 ], but it was comparable to those reported elsewhere (range 1.9–9.5%) [ 25 , 26 ]. The presently lower proportions of ASB may be related to the stringent definition, i.e.…”

“…The presently lower proportions of ASB may be related to the stringent definition, i.e. including only Enterobacterales as significant organisms, whereas in most other studies with higher ASB proportions, Staphylococci represented a substantial number of cases [ 17 , 22 – 24 ].…”

The Direct Semi-Quantitative Detection of 18 Pathogens and Simultaneous Screening for Nine Resistance Genes in Clinical Urine Samples by a High-Throughput Multiplex Genetic Detection System

“…The most important difference between urine samples and other clinical samples (such as blood) in the diagnosis of pathogens is the need for specific quantification when diagnosing a case of UTI. Previous studies reported that bacterial loads below 10 5 CFU/mL were considered to be UTInegative while bacterial loads above 10 5 CFU/mL were considered to be UTI-positive or diagnosed as having significant bacteriuria (Hansen et al, 2013;Belete et al, 2019;Gebremariam et al, 2019;Karikari et al, 2020). Other studies opted to use lower colony counts of >10 4 CFU/mL as an indicator of significant bacteriuria (Milovanovic et al, 2019;Schuh et al, 2019).…”

Pattern of microbial flora and antibiotic sensitivity among healthy adults with bacteriuria in a university community in south-eastern Nigeria

“…Asymptomatic bacteriuria is the presence of bacteria in the urine of an individual that does not have symptoms and signs of urinary tract infection, provided that the urine was collected without contamination [6][7][8][9] . Patients with asymptomatic bacteriuria show no obvious symptoms and appear clinically normal.…”

“…Patients with asymptomatic bacteriuria show no obvious symptoms and appear clinically normal. Several researches have been conducted on asymptomatic bacteriuria in varying age-groups and cohorts [6][7][8][9] . Delzell and Lefevre 6 documented a global prevalence of 2 -10%.…”