Prevalence of Asymptomatic Bacteriuria and its Antibacterial Susceptibility Pattern Among Pregnant Women Attending the Antenatal Clinic at Kanpur, India

Abstract

IntrOductIOnUrinary Tract Infections (UTIs) commonly occur pregnancy, due to the morphological and physiological changes that take place in the genitourinary tract. UTIs are of two types, symptomatic and asymptomatic. Asymptomatic Bacteriuria (ASB) is defined as the presence of actively multiplying bacteria, which is greater than 105/ ml of urine within the urinary tract, excluding the distal urethra, at a time when the patient has no symptoms of a UTI [1]. ASB can be found in both pregnant and non-pregnant women. The prevalence of ASB was found to be 2-11% in pregnant women. Pregnancy enhances the progression from ASB to symptomatic bacteruria, which could lead to acute pyelonephritis in 20-50% of cases and to adverse obstetric outcomes such as prematurity, postpartum hypertensive disease, anaemia, UTIs, and higher foetal mortality rates, if it is left untreated [2,3]. Asymptomatic bacteriuria is a microbial diagnosis which is based on the isolation of a specified quantitative count of bacteria in a specimen of urine which is properly collected from a pregnant woman who does not have any signs or symptoms. Thus, urine culture is the gold standard screening technique for ASB which occurs during pregnancy [4,5]. The predominant organism that causes UTIs during pregnancy is Escherichia coli, which accounts for 80-90% of infections [6]. The relatively high prevalence of ASB during pregnancy, the significant consequences faced by women and their pregnancies, and the ability to avoid undesired outcomes with treatment, justify screening and treatment of ASB in pregnancy. The frequencies of isolated pathogens and their antimicrobial resistance patterns can vary in different geographical regions [7]. Therefore, the most common Microbiology Section causative agents should be investigated and communities should be made aware of their local antimicrobial resistances. The objective of this prospective study was to identify the prevalence of ASB, its most common causative microorganisms and the antibacterial susceptibilities of the isolated microorganisms among pregnant women who attended a tertiary care centre at Kanpur, India. MAterIAls And MethOdsThis was a prospective study which was conducted in the Department of Microbiology and Department of Obstetrics in Rama Medical College Hospital and Research Centre, over a period of 6 months, starting from 1 st November 2012 to 30 th April 2013. A total number of 300 pregnant women who attended antenatal clinic were included in this study. Pregnant women with a history of UTI symptoms (dysuria, frequency and urgency, etc), pregnancy induced diabetes mellitus/ hypertension, a history of antibiotic therapy taken in the previous two weeks, pyrexia of unknown origin, known congenital anomalies of the urinary tract, were excluded from this study. After getting clearance from the ethical committee, study was conducted. Informed consents were taken from all the patients. Urine samples were collected by standard mid-stream "clean catch" method from all the pregnant women, in sterile, wi...

Correlation of Urinary Tract Infection Pathogens, Antibiogram and Age Group in Pregnant Women

“…These finding is similar to other reports which suggest that Gram-negative bacteria, particularly E. coli is the most common pathogen isolated in patients with UTI [2,5,[44][45][46][47]. The pattern of infection by E. coli, S. aureus and K. pneumoniae obtained in this study is in agreement with other study reported by [17], showing similar infection rate and pattern where E. coli (51.2%), S. aureus (27.3%), and K. pneumoniae (12.8%) respectively.…”

“…The pattern of infection by E. coli, S. aureus and K. pneumoniae obtained in this study is in agreement with other study reported by [17], showing similar infection rate and pattern where E. coli (51.2%), S. aureus (27.3%), and K. pneumoniae (12.8%) respectively. However, the 13.2% incidence rate of K. pneumoniae reported in this study is consistent with previous study [7], also this bring K. pneumoniae as predominant organism in UTI which lay out different status for this organism which disagree with other studies reported by [5,[48][49][50]. Adding to that prevalence of S. aureus in UTI in this study is in agreement with other reports [8], but disagrees with earlier study by [51].…”

“…The low activity ranges are consistent with other studies [6,7]. The high activity rate of antibiotic reported in this study disagree with other studies [5,53], that might be due to low number of isolate in the study.…”

“…Age group 38-42 year exhibited the highest prevalence of UTI although. age group 28-32 year showed higher percentage of isolates, this indicate that UTI increase with age [5,10]. Mean while P. aeruginosa is one of the least common organism isolated in this study among other S. faecalis and P. mirabilis which still impressive and should be considered for future treatment.…”

“…Many studies reported the significance of UTI during pregnancy although pregnancy does not cause UTI [3][4][5][6], however, the complexity of urinary tract system and changes during pregnancy account for susceptibility to infection [3][4][5]7,8] Urinary tract infections have been reported in all age groups and can occur in both sexes [2,9] and pregnant women are not an exception [5,6]. UTI is a serious health problem worldwide affecting millions of people each year and the leading cause of Gram-negative bacteria [9,10].…”