Screening for asymptomatic bacteriuria during pregnancy

Abstract

Introduction: UTIs are the most common bacterial infection during pregnancy. Asymptomatic bacteriuria is common in women due to short urethra and close proximity of perineum to the anal region. It is more common in elderly patients and in pregnancy due to progestrone effect in addition to different morphological and physiological changes during pregnancy. Detection of ASB in antenatal women is important, as, undetected and evaluated ASB may lead to symptomatic infection during pregnancy, acute pyelonephritis, postpartum UTI, anaemia, preterm labour, LBW, perinatal death of the fetus. Urine culture is the gold standard screening technique for ASB during pregnancy. Aims and Objectives: To find out the prevalence of ASB in pregnant women and to find the pattern of causative organism. Material and Methods: A total of 500 pregnant women aged between 18 to 35 years were studied over a period of 1 and 1/2 years at GMC, Amritsar. Clean midstream urine samples were collected into a sterile container and then subjected to culture method. Results: Out of the 500 pregnant women, 78 (15.6%) had significant bacteriuria. High percentage of ASB was seen in 2 nd trimester (52.56%). (E. coli) (53.8%) was the most common organism followed by Staphylococcus aureus (17.9%). Conclusion: ASB is not uncommon in antenatal patients. All pregnant women should be screened by urine culture to detect ASB at their first visit to prevent overt UTI and other complications in both mother and fetus.

Asymptomatic Bacteriuria, Prevalence Report during Antenatal Period at Pumhsw Nawabshah, Pakistan

“…The prevalence of ASB eastern Saudi Arabia [4] was 14.25%, this frequency is close to the frequency of our study. In Nepal study by Yadav [22] the prevalence was 42% [16] a very high frequency, 7.3% of cases were recorded from another city of India Kanpur [23], Goyal [11] from Amritsar India document the prevalence was 15.6% and the prevalence 10.2% was recorded in Bangladesh a study carried by Jubaida [24]. The total recorded frequency of ASB in Egypt [25] was 10%.…”

“…When compared the reported prevalence of antenatal asymptomatic bacteriuria with symptomatic UTI is 2% to 15% respectively [10]. ASB is defined as the presence of bacterial organisms more than 10 [5] per ml of urine, in a midstream of properly collected urine sample, without symptoms organisms, with a positive urine culture growth [11]. There is increasing the risk of ASB and symptomatic bacteriuria in pregnancy due to several hormonal and anatomical changes such as pressure of gravid uterus on ureters and urinary bladder which causes bacteriuria due to stasis of urine and reduced immunity [12].…”