<p>Bacterial Profile and ESBL Screening of Urinary Tract Infection Among Asymptomatic and Symptomatic Pregnant Women Attending Antenatal Care of Northeastern Ethiopia Region</p>

Abstract

Background: Urinary tract infection is a common cause of morbidity in pregnant women. Emergence of antimicrobial resistance particularly ESBL production among bacterial uropathogens is increasing and becoming principal cause of treatment failure. The aim of this study was to determine the bacterial profile, their antimicrobial susceptibility patterns, risk factors and identify ESBL-producing bacterial uropathogens. Patients and Methods: A hospital-based cross-sectional study was conducted in the Northeastern Ethiopia region. A total of 323 pregnant women were included and structured questionnaire was used to collect sociodemographic and risk factor-related data. About 10mL freshly voided midstream urine specimen was collected, transported and processed according to standard operating procedures. The data obtained were entered into SPSS version 22 and descriptive statistics, chi-square, bivariate and multivariate logistic regression analyses were performed. P-value ≤0.05 with corresponding 95% confidence interval were considered for statistical significance. Results: The overall prevalence of UTI was 15.5% (50/323). The predominant bacterial isolates were Escherichia coli 17 (33.3%) followed by coagulase-negative staphylococci 15 (30.0%) and Staphylococcus aureus 14 (27.5%). Previous history of UTI (AOR=8.824, 95% CI: 3.769,20.654, P<0.001) and history of catheterization (AOR=3.270, 95% CI: 1.316,8.122, P=0.011) were significantly associated with the occurrence of bacterial UTI. Gram-negative isolates showed high level of resistance to ampicillin 12 (60.0%) and relatively low level of resistance to nitrofurantoin 5(25.0%), norfloxacin 5 (25.0%) and ceftazidime 3 (15.0%). Gram-positive uropathogens showed higher resistance for penicillin 29 (93.5%) and trimethoprim-sulfamethoxazole 23 (79.3%) whereas all isolates were sensitive 29 (100.0%) to nitrofurantoin. Moreover, multidrug resistance was observed among 41 (80.4%) of the isolates, and 3 (15.8%) of isolated gram-negative bacteria were ESBL producers. Conclusion: High prevalence of bacterial UTI and MDR for commonly prescribed drugs were observed with significant number of ESBL producers. Therefore, instant UTI culture assessment of pregnant women, especially those having possible risk factors such as previous histories of UTI and catheterization; moreover, appropriate prescription and use of antibiotics are necessary.

Prevalence and Antimicrobial Susceptibility Pattern of Urinary Tract Infection among Pregnant Women Attending Hargeisa Group Hospital, Hargeisa, Somaliland

“…In the current study, participants with the previous history of indwelling catheterization had about 3.2 times chance of developing UTI [P= 0.012 AOR=3.216 (1.287, 8.038)] among pregnant women. This nding agrees with similar reports from Northeastern Ethiopia, Addis Ababa, Ethiopia and Gonder Ethiopia 21,33,46 . This could be due to long duration of catheterization, frequent catheterization or contamination during inserting catheters.…”

“…In this study the symptomatic study was 9.5%, These result of symptomatic UTI were agree with a study conducted from in Khartoum Sudan 12.1% 23 , in Makkah, Saudi Arabia 12% 26 and in Northeastern Ethiopia 11.9% 33 . But higher prevalence rate in Mekelle Northern Ethiopia 21.1% 34 , in Bangladesh 17.9% 35 , in in Goba and Sinana Woredas, Bale Zone, Southeast Ethiopia 35.3% 36 and in South-western Uganda 35% 37 .…”

“…This could be due to the relation of low socioeconomic status with nutrition and immunity especially in pregnant women. In contrast studies were done in Jigjiga, Ethiopia, Medan, Indonesia, and Northeastern Ethiopia 33,45,59 .…”

Antimicrobial Resistance among Pregnant Women with Urinary Tract Infections Attending Antenatal Clinic at Levy Mwanawasa University Teaching Hospital (LMUTH), Lusaka, Zambia

“…In Zambia, like many other countries, there is emerging evidence of AMR in several pathogens [11][12][13]. Despite the large number of antimicrobial agents available, UTIs have remained a significant problem among pregnant women in Zambia [14], particularly in Lusaka.…”

Bacterial Profile and asymptomatic bacteriuria among pregnant women in Africa: A systematic review and meta analysis

“…et al. [26] 2020 Ethiopia East Clean catch midstream urine cross sectional 244 29 10 11.8 (7.8, 15.9) 9 Chaula T., et al. [27] 2017 Tanzania East Clean catch midstream urine cross sectional 234 39 10 16.6 (11.8, 21.4) 10 Chukwu OS., et al.…”