Prevalence of asymptomatic bacteriuria and antimicrobial resistance profile among pregnant females in a Tertiary Care Hospital

Agarwal, Anjali; Pandey, Shreya; Maheshwari, Ujjwal; Singh, Mastan; Srivastava, Jyoti; Bose, Seema

doi:10.4103/ijcm.ijcm_792_20

Cited by 7 publications

(3 citation statements)

References 14 publications

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“…In the multivariate analysis, a previous history of UTI emerged as highly significant, along with other co-morbid conditions such as diabetes. The association between UTI and diabetes as predisposing factors was also corroborated by Nguefack et al [ 21 ] and other studies [ 22 , 23 ].…”

Section: Discussionsupporting

confidence: 75%

Risk Factors and Clinical Outcomes of Asymptomatic Bacteriuria in Pregnant Women: A Comprehensive Analysis

Mishra,

Kalra,

Bhide

et al. 2024

Cureus

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BackgroundAsymptomatic bacteriuria (ASB) in pregnant women poses risks to maternal and neonatal health. Understanding its prevalence and associated risk factors is crucial for effective management. This study aimed to determine the prevalence of ASB among pregnant women and identify associated risk factors. MethodologyA cross-sectional study involving 294 pregnant women was conducted. ASB prevalence was determined, and bivariate analysis was performed to identify associated risk factors. Logistic regression analysis was employed to assess the significance of identified risk factors. ResultsThe overall prevalence of ASB was 17.34%. Bivariate analysis revealed associations between ASB and maternal age (p > 0.05), socioeconomic status (p < 0.001), previous urinary tract infection (UTI) history (p < 0.001), diabetes mellitus (p = 0.00204), and anemia (p = 0.522). Multivariate logistic regression confirmed significant associations of ASB with maternal age (p = 0.008), parity (p = 0.001), previous UTI (p < 0.001), and diabetes mellitus (p < 0.001). ConclusionThis study underscores the importance of screening for ASB during prenatal care, particularly among pregnant women with advanced maternal age, higher parity, previous urinary tract infection (UTI) history, and diabetes mellitus. Tailored screening strategies and prompt treatment can mitigate the risks associated with untreated ASB, improving maternal and neonatal outcomes. Healthcare providers should integrate these findings into routine antenatal care protocols to optimize maternal and fetal health.

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Section: Discussionsupporting

confidence: 75%

Risk Factors and Clinical Outcomes of Asymptomatic Bacteriuria in Pregnant Women: A Comprehensive Analysis

Mishra,

Kalra,

Bhide

et al. 2024

Cureus

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“…Not all genera are equivalent when the goal is to diagnose ASB in patients. The taxa considered significant for ASB diagnosis include Escherichia coli, Enterococcus species (i.e., E. faecalis and E. faecium ) , Klebsiella species (especially K. pneumoniae ) , coagulase-negative Staphylococcus species (especially S. saprophyticus ), Pseudomonas, and Group B Streptococcus (i.e., S. agalactiae ) ( 26 , 27 ). The set of conditional probabilities for these and other urobiome genera is presented in Tables 2 and 3 for the EQUC and amplicon microbiome methods, respectively.…”

Section: Resultsmentioning

confidence: 99%

First trimester “clean catch” urine and vaginal swab sample distinct microbiological niches

Sung,

Larsen,

Halverson

et al. 2024

Microbiol Spectr

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Untreated asymptomatic bacteriuria (ASB) has been associated with adverse pregnancy outcomes. Thus, routine screening by standard urine culture (SUC) and treatment of ASB are currently recommended for all pregnant women. However, SUC often misses microbes detected by expanded quantitative urine culture methods (EQUC) and 16S rRNA gene (amplicon) sequencing. The existence of these microbes (urinary microbiome) challenges the current approach to ASB screening in pregnancy as it is limited by two assumptions: (i) the female bladder is naturally sterile and (ii) SUC identifies all clinically relevant uropathogens. To determine the uniqueness or similarity between urinary and vaginal microbiomes, we performed a prospective observational institutional review board (IRB)-approved cohort study of pregnant women with a singleton pregnancy <14 weeks undergoing routine ASB screening. Consented subjects provided paired midstream voided urine and vaginal swab samples, which were assessed by EQUC and amplicon sequencing. The similarity was determined by Spearman’s correlation; statistical significance was calculated using bootstrap analysis with 1,000 random samples and a significance threshold of P value < 0.001. We used the Bayes theorem to quantify how well the vaginal microbiome could be used as a proxy for a patient’s urinary microbiome and vice versa. Our findings provide evidence that EQUC and amplicon sequencing reveal similar views of urinary and vaginal microbiomes in first trimester pregnant women. However, while vaginal and urinary microbial compositions were significantly correlated for the same individual, they were by no means equivalent. The first trimester urinary and vaginal microbiomes are distinct enough to preclude their use as proxies of each other. IMPORTANCE Untreated asymptomatic bacteriuria (ASB) has been associated with adverse pregnancy outcomes, including pyelonephritis, preterm labor, and low birth weight infants. Thus, routine screening by standard urine culture (SUC) and treatment of ASB are currently recommended for all pregnant women. For this purpose, some researchers claim that vaginal swabs and urine samples can be used as proxies for each other. Because SUC often misses microbes, we used two more sensitive, recently validated detection methods to compare the composition of the urinary and vaginal microbiomes of pregnant females in their first trimester. Both methods yielded similar results. Vaginal and urinary microbial compositions for the same individual were significantly correlated; however, they were not equivalent. We argue that first trimester urinary and vaginal microbiomes are distinct enough to preclude their use as proxies for each other.

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“…Publication bias can be seen in Figure 3 . Outlier analysis shows 21 studies[ 16 , 17 , 22 , 25 , 31 , 32 , 34 , 37 , 39 , 45 - 47 , 49 , 50 , 52 , 56 , 57 , 60 , 62 , 65 , 67 ] (“Jayalaksmi 2008,” “Gayathree 2010,” “Chandel 2012,” “Mekapogu 2013,” “Titoria 2014,” “Sujatha 2014,” “Goyal 2015,” “Mukherjee 2015,” “Dange 2016,” “Giri 2017,” “Udayagiri 2017,” “Bose 2017,” “Maheshwari 2017,” “Patnaik 2017,” “Kant 2017,” “Shalima 2017,” “Rohini 2018,” “Mangalgi 2018,” “Goruntla 2019,” “Lakshmi 2019,” “Wagh 2019” ) as outlier. When these outliers were removed, percentage of ASB with random-effect model was 12.7% (11.5%, 13.9%), prediction interval (0.074, 0.181), and I 2 63.6% (46.5%, 75.2%).…”

Section: R Esultsmentioning

confidence: 99%

Prevalence of Asymptomatic Bacteriuria (ASB) in Pregnant Women in India: A Systematic Review and Meta-Analysis

Khapre,

Sharma,

Mehta

et al. 2023

Indian Journal of Community Medicine

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Background: Asymptomatic bacteriuria is prevalent during pregnancy. If it goes undetected, it can lead to urinary tract infection with severe maternal and neonatal complications. Until date, India does not have any guidelines to test for ASB during pregnancy. Objective: To estimate the pooled prevalence of asymptomatic bacteriuria in pregnant women at national level in India. Material and Methods: We searched Medline, Embase, Web of Science, and Google Scholar using search strategy with keyword. Two authors independently assessed the eligibility of study. The checklist of the JBI was used for evaluating the quality of reporting. The extracted data were analyzed, and the results were reported using a random-effects model with 95% confidence interval (CI). Subgroup analysis was conducted for zones of India, parity and trimester. Publication bias is reported as funnel plot. Result: Pooled prevalence of asymptomatic bacteriuria among pregnant women in India is 13.5% [CI 11.1; 15.8]. Subgroup analysis based on the various geographic zones of the country the pooled prevalence ranged from 9.2% in central zone to 14.8% in south zone. Distribution of prevalence of ASB as per parity was approximately identical. The prevalence of ASB was found to be high in third (21.8%). Conclusion: The prevalence of ASB is found to be high among Indian pregnant women, especially in third trimester. It is therefore recommended for guideline to screen and treat every pregnant woman for ASB to prevent further complications.

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Prevalence of asymptomatic bacteriuria and antimicrobial resistance profile among pregnant females in a Tertiary Care Hospital

Cited by 7 publications

References 14 publications

Risk Factors and Clinical Outcomes of Asymptomatic Bacteriuria in Pregnant Women: A Comprehensive Analysis

Risk Factors and Clinical Outcomes of Asymptomatic Bacteriuria in Pregnant Women: A Comprehensive Analysis

First trimester “clean catch” urine and vaginal swab sample distinct microbiological niches

Prevalence of Asymptomatic Bacteriuria (ASB) in Pregnant Women in India: A Systematic Review and Meta-Analysis

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