Asymptomatic bacteriuria of pregnant women in a tertiary care centre

Abstract

BACKGROUND: Asymptomatic bacteriuria (ASB) is commonly seen during pregnancy due to the various morphological, hormonal, and physiological changes the body undergoes. If left undiagnosed, it can lead to conditions such as pyelonephritis and preterm delivery which could culminate in causing maternal and fetal morbidity and mortality. Therefore, this study aims to determine the prevalence, risk factors, microbial profile, and antibiotic susceptibility patterns associated with ASB in a tertiary healthcare center. MATERIALS AND METHODS: A cross-sectional study was carried out where 150 urine samples were obtained from pregnant women within the gestational age of 13–36 weeks. Randomized stratified sampling was the method of sampling used. A questionnaire was also administered to them to determine potential risk factors. The samples were cultured and identified using biochemical tests. Antibiotic susceptibility tests were carried out by Kirby–Bauer disc diffusion method. Statistical analysis was carried out using Chi-square test. The graphs and tables were generated using Microsoft Excel and Word. RESULTS: Out of the 150 samples that were obtained, 8 samples had significant bacteriuria which is a prevalence of 5.33%. Escherichia coli was the most frequently isolated organism accounting to 45% of the isolates. The other organisms that were isolated were Enterococcus, Klebsiella pneumoniae, Coagulase negative staphylococcus (CONS), Candida albicans, and Group B Streptococcus which measured to 11% of the total distribution each. In the antibiotic sensitivity tests, among the gram-negative isolates, marked resistance to Ampicillin and Amoxycillin along with sensitivity to Cotrimoxazole and Nitrofurantoin. Of the gram-positive isolates, there was sensitivity to Ampicillin and Nitrofurantoin. A positive correlation was seen between the age groups of 23–27 and the prevalence of ASB. CONCLUSION: The prevalence of ASB in this study shows that ASB is not uncommon in the population. Despite the World Health Organization (WHO) guidelines and National Health Mission recommendations to make urine check-ups a routine, it not carried out, possibly due to cost implications. However, it poses a risk for severe maternal and fetal outcomes and hence, should be screened for on a regular basis. Thus, this study emphasizes the importance of screening pregnant women for ASB for promoting better maternal and fetal health.

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

“…Nitrofurantoin and trimethoprim-sulfamethoxazole showed high efficacy across all bacterial strains, similar to the findings of Totadhri et al [ 18 ]. Lower sensitivity to other antibiotics can be attributed to empirical use [ 19 ].…”

“…Escherichia coli was the most prevalent strain found in this study. Several studies have reported it to be the most common [ 17 , 18 ]. This phenomenon may be attributed to the common occurrence of urinary stasis during pregnancy.…”

Gambaran Pola Kuman dan Sensitivitas Antibiotik pada Ibu Hamil dengan Bakteriuria Asimtomatik yang Berobat ke RSUD dr. Zainoel Abidin

“…Pola bakteri pada penelitian ini sama dengan hasil penelitian yang dilaporkan Mohebi ., dkk di India, dari 150 sampel penelitian didapatkan delapan pasien yang mempunyai hasil kultur urin positif. Escherichia coli merupakan penyebab terbanyak (45%), diikuti Klebsiella pneumoniae, Coagulase negative staphylococcus (CONS), Candida albicans, dan Group B Streptococcus (Mohebi dkk., 2018). Escherichia coli merupakan penyebab terbanyak bakteriuria asimtomatis pada penelitian di Arab Saudi yaitu 44,26%, Group B Streptococcus 23,77%, Klebsiella pneumoniae 15,57%, dan Enterococcus faecalis 9,02% (Alshamlan dkk., 2022).…”

Current research update on group B streptococcal infection related to obstetrics and gynecology

“…Understanding the susceptibility of GBS to antibiotics can guide the selection of clinical treatment ( Husen et al, 2023 ). Commonly used antibiotic susceptibility testing methods include: disc diffusion method ( Totadhri et al, 2022 ), where paper discs containing different antibiotics are placed on a culture medium to observe the relationship between bacterial growth and inhibition zones; broth dilution method ( Stepanović et al, 2003 ), which gradually dilutes different concentrations of antibiotics in a culture medium to observe the minimum inhibitory concentration; E-test ( Persson et al, 2008 ), which uses a gradient concentration of antibiotics on a strip to observe the relative position between bacterial growth and inhibition zones. These methods can be used to determine the susceptibility of GBS to a specific antibiotic, helping doctors choose appropriate drugs for treatment.…”