Asymptomatic bacteriuria among pregnant women referred to outpatient clinics in Sanandaj, Iran

Abstract

Objectives: Determine the prevalence of asymptomatic urinary tract infection (AUTI) among pregnant women. We also determined the antibacterial susceptibility of the isolates to various antibiotics and associated risk factors in AUTI. Materials and Methods: One thousand five hundred and five consecutive pregnant women were included in the study. Mid-stream urine specimen for complete examination of urine was obtained. Results: Of 1505 pregnant women, 134 (8.9%) had bacteriuria. The mean age of the all the pregnant women included in the study was 28.40 years with a standard deviation of 6.16. Age ranged from 15 to 45 years of age. The urine culture of the asymptomatic pregnant women (1505 cases) showed growth in only 134 cases (8.9%). Escherichia coli was the commonest organism 79 (58.96%) followed by CN Staphylococcus 22 (16.8%) and S aureus 18 (13.43%). Escherichia coli, which comprised 58.96% (79) of the isolates, were 88.62%, 87.35%, and 83.55% sensitive to cefotaxime, ciprofloxacin and cefotizoxime respectively. Similarly, E. coli were 89%, 70%, and 20% resistant to ampicillin, cotrimoxazole, and nitrofurantoin respectively (OR 1.57 95% CI 1.01, 2.44). After analyzing, four variables, hemoglobin levels seem to be independently associated with asymptomatic bacteriuria . Conclusion: Prevalence of asymptomatic bacteriuria among pregnant women was 8.9%. The predominant organisms were Escherichia coli 58.96% (79%), followed by CN Staphylococcus 22 (16.8%). Most strains of Escherichia coli showed that they were resistant to ampicillin, tetracycline and gentamicin.

Prevalence of Asymptomatic Bacteriuria and its Antibacterial Susceptibility Pattern Among Pregnant Women Attending the Antenatal Clinic at Kanpur, India

“…Those women who show positive cultures should be treated as per antimicrobial sensitivity patterns of the bacteria which are isolated from their samples, to prevent maternal and foetal morbidities. In this study, the prevalence of asymptomatic bacteriuria was 7.3%, which was similar to those seen in various other studies [2,[9][10][11][12][13][14]. Neupane et al, (26%) and Imade et al, (45.3%) reported a higher prevalence [15,16].…”

“…Different studies done by Chandel et al, [11], Enayat et al, [12], Obirikorang et al, [13], Imade et al, [16], Khattak et al, [22], Jain et al, [23], as significant and insignificant according to the standard criteria. The organisms were identified by routine methods from the samples which showed significant bacteriuria.…”

“…Gram positive microorganisms were found to be important causes of ASB in some studies. Enayat et al, [12] reported that upto 16.8% of the causative organisms were Coagulase negative Staphylococcus. Enterococus faecalis was the most common Gram positive microorganism (4.5%) which was found in our study, which correlated with Sevki et al,'s findings [2].…”

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“…CoNS is one of isolated uropathogens [25]. In another study CoNS was second most common (16.8%) after E. coli (58.96%) [26]. In this study E. coli was second most common (23.5%) bacteria after CoNS (29.4%).…”

“…The bacteria were more susceptible to gentamycin, ceftriaxone and ciprofloxacin but resistant to nitrofurantoin and ampicillin. Nitrofurantoin is a widely recommended antibiotic for ASB treatment in pregnancy and it is associated with 80% cure rate with a 5 to 7 day course [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. Suggested first line treatment include amoxil, nitrofurantoin and oral cephalosporins and gentamycin and ceftriaxone for staphylococcus and pseudomonas [30,31].…”