Asymptomatic bacteriuria and symptomatic urinary tract infections in pregnancy

Abstract

Symptomatic and asymptomatic bacteriuria is common in pregnant women. A history of previous urinary tract infections and low socioeconomic status are risk factors for bacteriuria in pregnancy. Escherichia coli is the most common aetiologic agent in both symptomatic and asymptomatic infection and quantitative culture is the gold standard for diagnosis. Treatment of asymptomatic bacteriuria has been shown to reduce the rate of pyelonephritis in pregnancy and therefore screening for and treatment of asymptomatic bacteriuria has become a standard of obstetrical care. Antibiotic treatment of asymptomatic bacteriuria is associated with a decrease in the incidence of low birth weight, but the methodological quality of the studies limits the strength of the conclusions that can be drawn. Debate exists in the literature as to whether treated pyelonephritis is associated with adverse fetal outcomes. There is no clear consensus in the literature on antibiotic choice or duration of therapy for infection. With increasing antibiotic resistance, consideration of local resistance rates is necessary when choosing therapy.

Urinary Tract Infection among Pregnant Women at Pumwani Maternity Hospital, Nairobi, Kenya: Bacterial Etiologic Agents, Antimicrobial Susceptibility Profiles and Associated Risk Factors

“…Pregnant women are more susceptible to UTIs due to a combination of hormonal and physiologic changes that predispose them to bacteriuria [1]. The incidence of acute pyelonephritis in pregnant women is also significantly increased [2]. Factors such as history of recurrent urinary tract infection, diabetes, low social economic status, increasing maternal age, multiparity, and anatomical abnormalities of the urinary tract have also been associated with a two fold increase in bacteriuria during pregnancy [2], but the risk factors associated with UTIs in Africa remains poorly investigated.…”

“…The prevalence has remained constant and most of the recent observational studies, including those from developing countries, report almost similar rates [2]. The most common agent implicated in symptomatic and asymptomatic bacteriuria is Escherichia coli that is responsible for 70% -80% of the infections [4].…”

Determination of Prevalence of Urinary Tract Infection Among the Pregnant Women with Lower Abdominal Pain

“…If urinary tract infection is not controlled, it can badly affect the health of fetus and pregnant women 7,8 . Urinary tract infection during pregnancy may be symptomatic or asymptomatic 9,10 . The involvement of lower and upper urinary tract can lead to asymptomatic bacteriuria and symptomatic bacteriuria, respectively.…”

A Rural Based Study on Gestational Symptomless Bacteriuria (Gsb)

“…In catheterized urine sample, bacterial count as low as 100 colony forming units / ml are also considered significant bacteriuria. 7 It indicates actively multiplying bacteria within the urinary tract. Apart from urine culture, less expensive poor accuracy, rapid urine testing methods like dipstick test or nitrite or dipslide for leukocyte esterase or by urinary microscopy can be used for purpose of screening in case of population of low prevalence.…”