Asymptomatic UTI in pregnancy attending at tertiary care of Nepal

Abstract

Background: Urinary tract infections (UTI) during pregnancy issued by improper laboratory investigations situate women at risk of several detrimental complications. Untreated asymptomatic UTI (AUTI) may lead to pyelonephritis preterm birth, low birth weight, etc. Urine culture is used to confirm the diagnosis of UTI. Aim of this research was to carry out to find the prevalence of asymptomatic UTI and to establish antimicrobial drug susceptibility of the pathogens resulting asymptomatic UTI in pregnant women attending at tertiary care, Nepal.Methods: The urine samples were collected by mid-stream clean catch method from 600 pregnant women of age 15-45 years (mean age – 28.84 years) visiting for antenatal check up in the Department of Gynaecology and Obstetrics, Chitwan Medical College (CMC), a tertiary care of Nepal. All the urine samples were subjected to bio-physical, biochemical, microscopic, and microbiological analysis. The prevalence of UTI in three trimesters and in different age groups was obtained together with antimicrobial drug susceptibility tests.Results: On overall l51.83% of urine samples revealed with significant bacteriuria considered as the AUTI. On One- way ANOVA test, there was significant (P< 0.045) prevalence of AUTI when compared among different trimesters, though higher prevalence being in the first (40%) and second (45.33%) trimesters. The prevalence of AUTI was significant (P<0.004) among different age groups of the pregnancy. However, the most affectecd age groups were between 21-29 years. Escherichia coli were the most implicated organism (67.8%) followed by Klebsiella pneumonia (21.6%). The gram-negative bacteria (E. coli, K. pneumonia, and K. oxytoca) were more sensitive against Amikacin, Gentamycin, Meropenem, and Nitrofurantointhan. Other drugs whereas; gram positive bacteria (E. feacalis) had high susceptibility with Vancomycin.Conclusions: There was high incidence of AUTI among the pregnant ladies in the study region; therefore, microbial screening of urine of all pregnant women are must and should be included in the routine antenatal checkups to detect the AUTI to cut down and prevent the maternal and obstetric detrimental complications in them.

Prevalence of Asymptomatic Bacteriuria during Pregnancy at a Tertiary Care Hospital of Province No. 2, Nepal

“…The highest number of UTI cases found during pregnancy was in between 21 and 25 years. Similar fi nding was also obtained by Adeyeba et al in 2002, Amadi et al in 2007, Akinleye et al in 2014, Valentina and Srirangaraj in 2016and Yadav and Yadav in 2018. This could be recognized that the subjects with this age group are sexually more active which could favor the incidence of UTIs (Dutta 2008;Adeyeba et al 2002).…”

“…The increase in antibiotic resistant pattern could be due to antibiotic abuse due to lack of knowledge to health practitioner and consumer. Also, the low cost and availability of antibiotics without prescriptions in this area could be another contributing factor for antibiotic abuse, and thus the resistance (Yadav and Yadav, in 2018)…”

Asymptomatic bacteriuria of pregnant women in a tertiary care centre

“…The sample size of 150 was calculated from the standard formula of where p is the prevalence obtained from a study conducted in Nepal,[ 9 ] and d is the precision. The participants of the study were recruited through non-probability consecutive sampling method.…”

Maternal and Perinatal Outcome of Urinary Tract Infection in Pregnancy at Dhulikhel Hospital, Kathmandu University Hospital

“…5 In most studies, UTI is defined as "microscopic findings of more than ten pus cells per high power field (40x) in urine. 6,7 Positive urine culture is defined as significant growth of microbial organism(s). Negative urine cultures include those with no growth, with an insignificant quantity of growth or those with mixed growth due to probable contaminants.…”