scholarly journals Bacteriuria in Pregnant and Non Pregnant Women in Benghazi - Comparative Study

Author(s):  
Khaled Ali Mohamed Al-Mehdawi

Background: Bacteriuria is associated with significant maternal and foetal risks. However, its prevalence is not well known in our community. Objectives: Determine the prevalence and predictors of bacteriuria in women of the Benghazi, Libya as well as the antibiotic sensitivity patterns of bacterial isolates. Methods: Across-sectional study was carried out amongest pregnant and non-pregnant women attending many polyclinics in Benghazi. We recruited 120 consenting women (60 pregnant and 60 non pregnant) for the study. Demographic and clinical data were collected using structured questionnaire. Clean catch midstream urine was collected from each participant. Samples were examined biochemically, microscopically and by culture. Significant bacteriuria was defined as the presence of 105 bacteria per ml of cultured urine. Identification and susceptibility of isolates was performed using API (BioMerieux, France Company) . Results: Significant bacteriuria was found in the urine of 13.3 % (16) of all women with prevalence of 16.7% in pregnant women. Asymptomatic bacteriuria was detected in 8.3 % (10). The most frequent isolates were Staphylococcus aureus (31.2%), E. coli (25%), Staphylococcus saprophyticus (18.9%), and were sensitive to gentamycin (GN) 87.5%, azithromycin (AZM)75%, and the less effective antibiotics were cephalexine (CL) and ampicillin (AMP). Conclusion: Bacteriuria is frequent in women particularly pregnant women suggesting the need for routine screening by urine culture, which would allow early treatment to avoid the complications. In addition, UTI infections appears to be multifactorial.

2015 ◽  
Vol 9 (07) ◽  
pp. 720-724 ◽  
Author(s):  
Mandira Mukherjee ◽  
Snehashis Koley ◽  
Sandip Kumar Mukherjee ◽  
Shreya Basu ◽  
Biplab Ghosh ◽  
...  

Introduction: Asymptomatic bacteriuria (ABU) in pregnancy generates medical complications. E. coli is the common etiologic agent responsible for ABU-associated infections. This study aimed to identify the phylogenetic background and drug resistance in asymptomatic E. coli from a pregnant population. Methodology: E. coli was confirmed biochemically from culture-positive urine samples collected from asymptomatic pregnant women. Phylogenetic typing was done by polymerase chain reaction (PCR). The isolates were subjected to antibiotic susceptibility testing and extended-spectrum beta-lactamase (ESBL) production. Statistical significance was determined using SPSS 17.0 software. Results: Bacteriuria was observed in 113 (22.6%) of 500 asymptomatic pregnant females. E. coli was reported in 44 (38.9%) of 113 isolates. The mean age-wise distribution was 25.14 ± 4.63. Although pathogenic phylogroup B2 was predominant (54.5%), incidence of non-pathogenic phylogroup B1 (27.3%) was found to be statistically significant (p ≤ 0.001), and B1 and B2 were correlated with respect to total ABU population. Antibiotic sensitivity against ampicillin (34.1%), ceftazidime (50%), cefotaxime (47.7%), ciprofloxacin (47.7%), amikacin (86.4%), nitrofurantion (79.5%), and co-trimoxazole (36.4%) was observed. Multidrug resistance (MDR) and ESBL production was reported in 26 (59.1%) of 44 and 18 (69.2%) of the 26 MDR isolates, respectively. A significant distribution of phylogroup B1 (p = 0.03) with drug resistance was also observed. Conclusions: This is the first study that reported significant incidence of non-pathogenic phylogroup B1 in asymptomatic E. coli with high incidence of MDR isolated from pregnant women in Kolkata, India.  These varied resistance patterns present major therapeutic and infection control challenges during pregnancy.


Author(s):  
Ahmed M. Abbas ◽  
Moustafa Kamel ◽  
Mohammed Z. Abdelrahman ◽  
Ahmed A. Youssef ◽  
Mohammed A. Youssef

Background: The current study aims to identify the prevalence of asymptomatic bacteriuria among low-risk pregnant women attending the antenatal care clinic of tertiary University Hospital and to detect the most common causative organisms.Methods: A prospective cross-sectional study conducted at a tertiary University Hospital in the period between 1st November 2017 and 31st June 2018. All eligible women attending the outpatient clinic for antenatal care were approached to participate in the study. The recruited women were assessed through detailed history and clinical examination. Urine samples were taken for culture and sensitivity within two hours, in order to avoid bacterial multiplication. Urine culture and antibiotic sensitivity test were done.Results: The study included 250 women. The mean age of included women was 25.89±5.49 (18-42 years). The urine analysis results showed that 32% of cases had pus cells >5 per high power field and 10.4% of cases have protein (+). Casts were present in 0.8% of cases. RBCs >5 per high power field were present in 4.8% of cases. ASB is defined as urine culture with more than 100,000 colony forming unit; this was present in 30 cases. This indicates that the prevalence of ASB among studied cases was 12%. Enterococcus was the most prevalent organism as it was present in 36.7% among positive cases. Antibiotic sensitivity test was performed to the growing organisms indicated that teicoplanin, imipenem, cefoxitin, cefotaxime + clavulanic acid, Entrapenem, and trimethoprim + sulfamethoxazole are the most effective antibiotics against the most common organisms causing asymptomatic bacteriuria.Conclusions: The prevalence of asymptomatic bacteriuria among low-risk pregnant women is about 12%. Urine culture for asymptomatic bacteriuria should be the standard of care for evaluation of pregnant patient during antenatal care as regard presence or absence of UTI.


Author(s):  
Legese Chelkeba ◽  
Korinan Fanta ◽  
Temesgen Mulugeta ◽  
Tsegaye Melaku

Abstract Background Globally, antimicrobial resistance (AMR) restricted the armamentarium of the health care providers against infectious diseases, mainly due to the emergence of multidrug resistant. This review is aimed at providing contemporary bacterial profile and antimicrobial resistance pattern among pregnant women with significant bacteriuria. Methods Electronic biomedical databases and indexing services such as PubMed/MEDLINE, Web of Science, EMBASE and Google Scholar were searched. Original records of research articles, available online from 2008 to 2021, addressing the prevalence of significant bacteriuria and AMR pattern among pregnant women and written in English were identified and screened. The relevant data were extracted from included studies using a format prepared in Microsoft Excel and exported to STATA 14.0 software for the outcome measure analyses and subgrouping. Results The data of 5894 urine samples from 20 included studies conducted in 8 regions of the country were pooled. The overall pooled estimate of bacteriuria was 15% (95% CI 13–17%, I2 = 77.94%, p < 0.001) with substantial heterogeneity. The pooled estimate of Escherichia coli recovered from isolates of 896 urine samples was 41% (95% CI 38–45%) followed by coagulase-negative Staphylococci, 22% (95% CI 18–26%), Staphylococcus aureus, 15% (95% CI 12–18%), Staphylococcus saprophytic, 12% (95% CI 6–18%) Proteus mirabilis, 7% (95% CI 4–10%), Enterococcus species, 6% (0–12%), Pseudomonas aeruginosa, 4% (2–6%), Citrobacter species, 4% (95% CI 2–4%), Group B streptococcus, 3% (1–5%), and Enterobacter species, 2% (1–4%). Multidrug resistance proportions of E. coli, Klebsiella species, Staphylococcus aureus and Coagulase negative staphylococci, 83% (95% CI 76–91%), 78% (95% CI 66–90%), 89% (95% CI 83–96%), and 78% (95% CI 67–88%), respectively. Conclusion The result of current review revealed the occurrence of substantial bacteriuria among pregnant women in Ethiopia. Resistance among common bacteria (E. coli, Klebsiella species, Staphylococci species) causing UTIs in pregnant women is widespread to commonly used antibiotics. The high rate of drug resistance in turn warrants the need for regular epidemiological surveillance of antibiotic resistance and implementation of an efficient infection control and stewardship program.


2017 ◽  
Vol 6 (2) ◽  
pp. 79-83
Author(s):  
Shakila Khanum ◽  
Jamal Uddin Ahmed ◽  
Khaleda Khanam

Background: Urinary tract infections (UTIs) are common during pregnancy. Untreated asymptomatic bacteriuria (ASB) during pregnancy may cause serious complications including pyelonephritis and delivery of premature or low-birth-weight infants. This study aimed to assess the risk factors for asymptomatic bacteriuria, bacterial agents and their antibiotic susceptibility pattern in pregnant women attending in Combined Military Hospital (CMH), Dhaka.Methods: This cross-sectional study was conducted in a total of 1540 pregnant women with no signs and symptoms of UTI from October 2013 to March 2015. Clean catch mid-stream urine samples were collected from all study participants using sterile containers. Urine samples were cultured using standard bacteriological methods. Identification of suspected colonies and antibiotic sensitivity testing were done. Patients having ASB were further evaluated to find out associated risk factors.Results: Out of 1540 pregnant women, 254 (16.5%) had asymptomatic bacteriuria (Colony forming unit >105/mL).The most frequently isolated bacteria were Escherichia coli (E. coli) (50.4%), followed by Klebsiella (24.0%). The antibiotic sensitivity rate of bacterial isolates were highest for imipenem and amikacin. Among different associated conditions, anemia (16.5%), gestational diabetes mellitus (GDM) (10%) and past history of UTI (5.1%) were found to be the most frequent factors associated with increased prevalence of ASB.Conclusion: In this study, the prevalence of ASB was high among pregnant women with anemia, GDM and past history of UTI. E. coli was the most common organism causing ASB, which is less susceptible to conventional oral antibiotics but more susceptible to imipenem and amikacin. So, careful drug selection is required for successful outcome in ASB.Birdem Med J 2016; 6(2): 79-83


Author(s):  
Shadrack Okaijah ◽  
Albert Abaka-Yawson ◽  
Philip Apraku Tawiah ◽  
Solomon Sosu Quarshie ◽  
George Yiadom Osei ◽  
...  

Background: The significance of asymptomatic bacteriuria (ASB) relates to its potential to cause acute pyelonephritis, preterm labour and preterm rupture of the membranes. Additionally, it has been associated with clinical conditions such as anaemia, preterm birth, low birth weight and perinatal mortality. Aim: This study, therefore, determined the prevalence of ASB among pregnant women attending the antenatal clinic.  Materials and Methods: A cross-sectional study using convenient sampling method was used to recruit 200 pregnant women attending antenatal care at the Korle-Bu Teaching Hospital (KBTH) from January – April 2014. Bacteriological, urine chemistry and routine urine analyses, as well as antibiotic susceptibility profile of bacterial isolates from mid-stream urine samples of pregnant women, were carried out using appropriate standard methods. Variables were reported in mean, standard deviation, percentages and bar graph. Chi-square test was used to establish statistical difference and association between variables where p-value <0.05 was considered statistically significant. Results: Out of the total participants, 23 had asymptomatic bacteriuria but no prevalence of ASB was found among Muslims. The association between marital status and the prevalence of ASB was significant (Pearson chi2 = 4.88, p-value = 0.027). Five bacterial isolates were obtained with Escherichia coli (43.6%) being the most prevalent organism. There were more negative reactions than positive reactions with regards to nitrite and leukocyte esterase determination. Both gram-positive and negative isolates recorded high susceptibility to Gentamicin and Norfloxacin. However, Ciprofloxacin showed a high rate of resistance to only gram-negative isolates whiles Chloramphenicol, Ampicillin and Amoxicillin showed high resistance to gram-positive isolates. Conclusions: The overall prevalence of asymptomatic bacteriuria was 11.5% [95%CI: 7.4% - 16.8%] among the referral pregnant women attending KBTH with Escherichia coli being the most prevalent organism whiles the most susceptible antibiotics were Gentamicin and Norfloxacin.


2016 ◽  
Vol 13 (2) ◽  
pp. 239-246
Author(s):  
ZB Muktha ◽  
SML Kabir ◽  
MT Rahman

This study was carried out during the period of July to December, 2014 in order to isolate and characterize bacterial flora present in the respiratory tract of healthy horses in and around BAU campus. Eighteen apparently healthy horses were used for the study. Swab samples were collected from the nasal cavity. The bacteria was isolated ,identified and characterized by cultural (aerobic condition),staining, biochemical and PCR technique. Each of the samples collected yielded at least one bacterial species. A total of 27 bacteria were isolated from the selected animals. The majority of the isolates (15/27, 55.56%) were Gram-positive and the rest (12/27, 44.44%) were Gram-negative. Bacterial isolates were Staphylococcus aureus (83.33%) and E. coli (66.66%).The antimicrobial susceptibility pattern of bacterial isolates was investigated by disc diffusion method. The antibiotic sensitivity test of Staphylococcus aureus revealed that the isolates were highly sensitive to ciprofloxacin, moderately sensitive to gentamicin and resistance to amoxicilin, ampicilin and erythromycin. On the other hand, E. coli showed moderately sensitive to ciprofloxacin and gentamycin, mildly sensitive to erythromycin and resistance to amoxicilin and ampicilin. Detection of E. coli and S. aureus from the respiratory tract of healthy horses were not unexpected. Ciprofloxacin and gentamicin could be used for therapeutic purpose, if diseases occur by these organisms in horses.J. Bangladesh Agril. Univ. 13(2): 239-246, December 2015


Author(s):  
K. Sri Sandhya ◽  
Ch. Pranuthi Mispah ◽  
Santosha Kelamane

Background: Asymptomatic bacteriuria (ASB) is common in pregnant women due to morphological and physiological changes in the genitor-urinary tract, which untreated may lead to complications like pyelonephritis and may also effect the fetus. The objective of our study was to determine the prevalence of ASB in pregnant women, to identify the organisms responsible and their antibiotic sensitivity pattern.Methods: A clean catch midstream urine was collected from 250 pregnant women in different trimesters attending antenatal OPD in a tertiary care hospital. Isolates and their antibiogram were obtained by conventional methods.Results: Among 250 pregnant women, 23(9.2%) had shown significant bacteriuria, and majority (52.1%) were in 3rd trimester. Escherichia coli (56.5%) was the commonest isolate followed by Klebsiella pneumoniae (17.4%). Most of the isolates showed sensitivity to imipenam, nitrofurantoin and cefepime.Conclusions: Asymptomatic bacteriuria is common during pregnancy which requires a routine examination of urine for culture and sensitivity and the positive cases should be treated with appropriate antibiotics to prevent any further complication.


2018 ◽  
Vol 5 (1) ◽  
pp. 179
Author(s):  
Prabhavathi V. ◽  
Krishnamma B. ◽  
Krishna Murthy G. ◽  
Prasad DKV

Background: The pregnant women are more commonly affected with asymptomatic bacteriuria (ASB) than non-pregnant women and its progression could lead to adverse maternal and perinatal outcomes. The study was designed with an aim to know the prevalence of ASB and its effects on maternal and perinatal outcome.Methods: In this prospective study, 300 antenatal women attending Anil Neerukonda Hospital were screened for ASB. Urine culture was performed using standardized Kirby-Bauer disc diffusion method on blood agar, Mac Conkey’s agar for antibiotic sensitivity testing. The screened antenatal women were divided into two subgroups viz. asymptomatic bacteriuria positive (Group I) and asymptomatic bacteriuria negative (Group II) depending on the culture study and were followed till delivery for maternal and perinatal outcomes.Results: The prevalence of ASB was 11.33%. Out of 34 cases of ASB positive, 8 cases (23.5%) were delivered with birth weight <2500 grams as compared to 11 cases (4.1%) in unexposed cases (RR 5.68, 95% CI; 2.46-13.15; p<0.05). Preterm low birth was noticed in 5 (14.7%) cases of ASB positive pregnant women with compared to unexposed cases (RR 1.5, 95% CI; 0.61-3.65, p=0.36). Regarding maternal outcomes, premature labour was observed in 8 cases (23.5%) of ASB exposed women whereas 22 (8.3%) in non-exposed cases (RR 2.84, 95% CI; 1.37-5.88, p=0.004). A significant number of women have developed hypertension (17.6%) and preeclampsia (8.8%) in ASB positive cases as compared to ASB negative cases (4.9% and 2.3% respectively).Conclusions: The prevalence of ASB was 11.33% in the present study. As one third of the cases were identified in early and late trimesters, regular and trimester wise screening need to be incorporated in routine antenatal screening for safe motherhood and new born health.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Ketema Bizuwork ◽  
Haile Alemayehu ◽  
Girmay Medhin ◽  
Wondwossen Amogne ◽  
Tadesse Eguale

Asymptomatic bacteriuria (ASBU) is an important health problem among pregnant women, particularly in low-income countries. This study aimed to estimate the prevalence of ASBU and potential risk factors among pregnant women attending antenatal care centers in Addis Ababa. It also aimed to identify causal bacterial pathogens and to assess their antimicrobial susceptibility. A health facility-based cross-sectional study was conducted from March to June 2019. Urine samples from a total of 281 pregnant women with no symptoms of urinary tract infection were tested for ASBU. Women whose urine samples carried greater than or equal to 105 colony-forming units (CFU) of bacteria per milliliter of urine when grown on plate count agar were considered positive for ASBU. Bacterial pathogens were isolated from urine samples of women with ASBU using standard microbiological techniques. Antimicrobial susceptibility of isolates was investigated using the Kirby–Bauer disk diffusion method on Muller–Hinton agar plates. Of 281 pregnant women examined, 44 (15.7%) were positive for ASBU. Logistic regression analysis of the putative risk factors tested in the current study showed that none of them were significantly associated with the occurrence of ASBU ( p > 0.05 ). The most frequently isolated bacterial species were Escherichia coli 17 (30.2%), Proteus 13 (23.2%), and Enterococcus 11 (19.6%). All of the E. coli, Citrobacter, and Klebsiella isolates and 84.6% of Proteus were resistant to ampicillin. All bacterial isolates were resistant to at least one of the antimicrobials tested. Resistance to three or more antimicrobials was detected in 15 (88.2%) of E. coli, 13 (100%) of Proteus, and 8 (72.7%) of Enterococcus isolates. Resistance to as many as 7 antimicrobials among E. coli, 8 antimicrobials among Proteus, and 7 antimicrobials among Enterococcus isolates was recorded. Detection of ASBU in a substantial number of pregnant women in this study warrants the need for a detailed study on possible risks of developing symptomatic urinary tract infection (UTI) and associated complications. Multidrug resistance to several antimicrobials was observed in the majority of bacterial isolates. Regular assessment of antimicrobial susceptibility of uropathogens to commonly prescribed antimicrobials and implementation of prudent use of antimicrobials are recommended.


2021 ◽  
pp. 1-8
Author(s):  
Naimshree Sonkar ◽  
Malay Banerjee ◽  
Suman Gupta ◽  
Absar Ahmad

Introduction: Asymptomatic bacteriuria (ASB) is the presence of actively multiplying bacteria within the urinary tract with absence of any symptoms, resulting in adverse pregnancy outcomes. This research study was done in order to review prevalence, antimicrobial susceptibility profile, and factors associated with ASB occurring in female patients who are pregnant and being treated at a tertiary care hospital in Lucknow, India. Method and Materials: This is a cross-sectional study done among 216 pregnant women attending a hospital for antenatal check-ups. Clean catch midstream urine samples were collected and examined microscopically, and semi-quantitative culture was done on blood agar and MacConkey agar. Isolates were identified by colony morphology and biochemical tests, and antimicrobial susceptibility testing was done by using the Kirby-Bauer method. Results: Of the 216 pregnant women, 36 (16.7%) tested positive for ASB. The female gestational period, haemoglobin level, and BMI were significantly associated with ASB. Logistic regression also showed that higher haemoglobin level was less likely to ASB (AOR = 0.42, 95% confidence interval: 0.202–0.88, p = 0.021). The predominant and usual isolates were E. coli (n = 22, 61.1%), followed by Cons (n = 6, 16.7%), and S. aureus (3, 8.3%). All Gram-negative isolates were mostly sensitive to most of the drugs like piperacillin-tazobactam, cefepime, nitrofurantoin, and meropenem but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to ampicillin, vancomycin, linezolid, and nitrofurantoin but 100% resistant to co-trimoxazole. Conclusion: The present study shows the existence of ASB was 16.7% among women who are pregnant. Pregnancy duration, haemoglobin level, and BMI were significantly associated with ASB. The isolates identified more frequently were E. coli (61.16%), Cons (16.7%), and S. aureus (8.3%). All isolates which were Gram-negative were mostly sensitive to most of the drugs but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to most of the drugs but 100% resistant to co-trimoxazole.


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