Prevalence and associated risk factors of asymptomatic bacteriuria among antenatal women attending a health care center: one year study

Abstract

Background: Asymptomatic bacteriuria is defined as presence of persistent and actively multiplying bacteria in urine in significant numbers, ≥10 5 /ml but without clinical symptoms. Detection of ASB is important during pregnancy as it leads to 25% of symptomatic urinary tract infection in pregnant mothers, pyelonephritis, hypertension in pregnancy, postpartum UTI, anemia, preterm labour, low birth weight and perinatal death of the foetus. The objective of the present study is to identify the prevalence of ASB among pregnant women, epidemiological pattern, risk factors associated with it, type of pathogens and their antimicrobial susceptibility. Methods: A prospective cross-sectional study was conducted on 500 asymptomatic antenatal women who fulfilled the inclusion criteria attending the department of Obstetrics and Gynecology. Mid stream urine specimen was collected from all the cases and subjected to microscopic analysis and culture and sensitivity. Results: Our study showed the prevalence of ASB as 7.6% among antenatal women.78.8% of sterile cases and 13.6% as contaminants. 21-25 years was the common age group of ASB cases in our study. ASB was common among multiparous women, during 3 rd trimester. Statistically significant association was observed with low socio-economic status, increases sexual activity and among illiterate cases. Escherichia coli (42.11%) was the most common isolate in the study. Other isolates were Klebsiella, Staphylococcus aureus, CONS, Citrobacter and Enterococcus sp. Imipenem, Meropenem exhibited 100% sensitivity for gram negative isolates and clindamycin for gram positive isolates. Conclusions: All the cases of ASB diagnosed should be treated based upon the culture and sensitivity report to prevent unnecessary prescription of antibiotics which can economically burden the patient as well pave a way in development of resistant strains. Hence, further initiatives should be undertaken to include urine culture sensitivity as a part of national screening programme to prevent maternal and foetal complications.

Prevalence of asymptomatic bacteriuria and antimicrobial resistance profile among pregnant females in a Tertiary Care Hospital

“…Gram-negative isolates were highly sensitive to nitrofurantoin, meropenem, imipenem, piperacillin-tazobactam, and fosfomycin in our study, which is similar to other studies. [ 10 21 22 23 ] In E. coli , norfloxacin is 50% resistant similar to other studies. [ 24 ] Ampicillin is nearly 50% sensitive in E. coli similar to another study.…”

“…[ 23 ] Most E. coli and Klebsiella isolates in our study were found nearly 80%–85% sensitive to nitrofurantoin which is concordance with other studies. [ 21 23 ] However, another study showed 100% sensitivity of nitrofurantoin to E. coli and Klebsiella [ 2 ] [ Table 3 ].…”

Asymptomatic bacteriuria of pregnant women in a tertiary care centre

“…Previous studies conducted in a comparable South Indian population by Cooly et al . [ 1 ] and Udawat et al . [ 11 ] have also shown similar prevalence rates.…”

“…Pregnant women are more susceptible to ASB because of the various morphological, hormonal, and physiological changes the body undergoes during gestation. The short-sized urethra and the proximity of the urinary tract to the anal canal in females poses an increased risk of contamination by fecal flora[ 1 ] which when combined with the apparent reduction in immunity during pregnancy along with the glycosuria that is seen in 70% of the women during gestation promotes a suitable environment for the proliferation of bacteria in the urinary tract. [ 2 ]…”