Asymptomatic bacteriuria in antenatal women attending tertiary care hospital at Hyderabad

Abstract

Urinary tract infection (UTI) is one of the most common bacterial infections during pregnancy. Increased risk of UTI in pregnant women is due to anatomical changes and physiological adaptations during pregnancy.Untreated asymptomatic bacteriuria (ASB) in pregnancy predisposes to symptomatic UTI in 25% of infected women.Early diagnosis and appropriate treatment of ASB curbs the risk of pyelonephritis, ecclampsia, preterm delivery and adverse fetal outcomes. This prospective study was conducted to determine the occurrence of ASB, its etiological agents and their antibacterial susceptibility pattern in selected group of pregnant women. Prospective study was carried out on in department of Microbiology at ESIC medical college, Telangana from September 2016 to March 2017. Study population included total of 346 antenatal women of gestational ages 28 weeks or less with no symptoms of urinary tract infection (UTI) attending for antenatal checkup. All bacterial isolates showing significant growth were identified by standard biochemical methods. The antibiotic sensitivity testing of the isolates was be done by Kirby Bauer method according to CLSI guidelines. Among total of 346 antenatal women screened 85.5% samples were sterile. Significant bacterial growth was found in 38 (11%) cases. The age, gravida and trimester of participants did not have any statistical significance on ASB in present study. Escherichia coli (42.1%) and Enterococcus faecalis (42.1%) were most common isolates. Antibiotic sensitivity pattern of Escherichia coli revealed good sensitivity to cefotaxime (93.75%), amikacin (87.5%), nitrofurantoin (87.5%) and cotrimoxazole (81%). Antibiotic sensitivity pattern of Enterococcus faecalis showed good sensitivity of 75% to nitrofurantoin and 67.5% to ampicillin, ciprofloxacin and high level gentamicin. Staphylococcus aureus showed 100% sensitivity to betalactam antibiotics and aminoglycoside.Every pregnant woman in each trimester should have a urine culture done and detected cases should be treated according to the antibiotic susceptibility test in order to reduce the perinatal and maternal morbidity and mortality.