Prevalence of Asymptomatic Bacteriuria among Pregnant Women Attending Antenatal Care at the Korle-Bu Teaching Hospital Accra, Ghana: A Cross-sectional Study

Abstract

Background: The significance of asymptomatic bacteriuria (ASB) relates to its potential to cause acute pyelonephritis, preterm labour and preterm rupture of the membranes. Additionally, it has been associated with clinical conditions such as anaemia, preterm birth, low birth weight and perinatal mortality.
 Aim: This study, therefore, determined the prevalence of ASB among pregnant women attending the antenatal clinic. 
 Materials and Methods: A cross-sectional study using convenient sampling method was used to recruit 200 pregnant women attending antenatal care at the Korle-Bu Teaching Hospital (KBTH) from January – April 2014. Bacteriological, urine chemistry and routine urine analyses, as well as antibiotic susceptibility profile of bacterial isolates from mid-stream urine samples of pregnant women, were carried out using appropriate standard methods. Variables were reported in mean, standard deviation, percentages and bar graph. Chi-square test was used to establish statistical difference and association between variables where p-value <0.05 was considered statistically significant.
 Results: Out of the total participants, 23 had asymptomatic bacteriuria but no prevalence of ASB was found among Muslims. The association between marital status and the prevalence of ASB was significant (Pearson chi2 = 4.88, p-value = 0.027). Five bacterial isolates were obtained with Escherichia coli (43.6%) being the most prevalent organism. There were more negative reactions than positive reactions with regards to nitrite and leukocyte esterase determination. Both gram-positive and negative isolates recorded high susceptibility to Gentamicin and Norfloxacin. However, Ciprofloxacin showed a high rate of resistance to only gram-negative isolates whiles Chloramphenicol, Ampicillin and Amoxicillin showed high resistance to gram-positive isolates.
 Conclusions: The overall prevalence of asymptomatic bacteriuria was 11.5% [95%CI: 7.4% - 16.8%] among the referral pregnant women attending KBTH with Escherichia coli being the most prevalent organism whiles the most susceptible antibiotics were Gentamicin and Norfloxacin.