Asymptomatic Bacteriuria among Pregnant Women Attending a Tertiary Care Hospital in Western Nepal: A Cross-sectional Prospective Study

INTRODUCTION Urinary tract of female undergoes tremendous changes during pregnancy which increases their risk of acquiring infection. Asymptomatic bacteriuria is a common entity among pregnant women which refers to significant bacteriuria (>105 bacteria per ml of urine) without any typical symptoms of urinary tract infection. Asymptomatic bacteriuria can lead to various maternal and fetal complications if not detected and treated on time. MATERIAL AND METHODS Total 280 urine samples were collected in sterile universal containers from pregnant women not showing typical symptoms of urinary tract infection at the time of sample collection. Urine samples were inoculated in both MacConkey agar and Blood agar by semi quantitative culture method. Culture plates were reported after 24 hours of incubation at 370C. Bacteria isolated were subjected to antibacterial susceptibility testing by modified Kirby-Bauer disc diffusion method. RESULTS Out of 280 urine cultures, 213 samples were sterile. Significant bacteriuria was seen in 25 cases (8.9%) followed by insignificant bacteriuria (20, 7.14%) and contamination (17, 6.10%). Highest number of cultures positive were in age group 21-30 years (19, 9.1%,). Out of 25 cases of significant bacteriuria, 60% were primigravida and 40% were multigravida. The most common organism isolated was Escherichia coli (10, 60%) followed by Klebsiella pneumoniae (5, 40%). CONCLUSION Screening of all pregnant women for asymptomatic bacteriuria is essential during their antenatal checkup. Escherichia coli is the commonest organism that cause asymptomatic bacteriuria. Appropriate antibiotic therapy is absolutely necessary for positive cases on the basis of antimicrobial susceptibility result to prevent unwanted obstetric complications.

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

Tribhuvan University Journal of Microbiology ◽

10.3126/tujm.v6i0.26576 ◽

2019 ◽

Vol 6 ◽

pp. 32-38

Author(s):

Khushbu Yadav ◽

Satyam Prakash

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Pregnant Women ◽

Antibiotic Susceptibility ◽

Tertiary Care ◽

Asymptomatic Bacteriuria ◽

Diffusion Method ◽

Care Hospital ◽

Antibiotic Susceptibility Test

Objectives: The objective of this study was to determine the prevalence of asymptomatic bacteriuria in pregnant women, identify the causative agent responsible for urinary tract infection (UTI) and its antibiotic susceptibility. Methods: The mid-stream urine sample was streaked on the MacConkey agar (MA) and Blood agar (BA) medium by the semi-quantitative culture technique. Identification of significant isolates was done by standard microbiological techniques. Antibiotic susceptibility test of the isolated organisms was done by modified Kirby Bauer disc diffusion method. Results: The prevalence rate of asymptomatic urinary tract infection (AUTI) among pregnant women was found to be 42%. The highest number of UTI cases found during pregnancy was in between age 21-25 years (52.22%), in second gravida (51.59%), during 3rd trimester of pregnancy (49.68%) and in winter with 52.22%. E. coli was principal organism to cause AUTI (35.48%) during pregnancy. Amikacin, imipenem and nalidixic acid were effective towards Gram negative bacilli whereas vancomycin, tetracycline and amoxyclav were effective towards Gram positive cocci. Conclusion: All pregnant women visited for antenatal checkups should be advised for the culture and sensitivity test of their urine specimens which will reduce the maternal and child health complications. Different screening test and awareness programme should be conducted at regular interval of time for prevention of AUTI during pregnancy.

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PSEUDOMONAS SPECIES CAUSING URINARY TRACT INFECTION AND ITS ANTIBIOGRAM AT A TERTIARY CARE HOSPITAL

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i11.20002 ◽

2017 ◽

Vol 10 (11) ◽

pp. 50

Author(s):

Shobha Kl ◽

Ramachandra L ◽

Amita Shobha Rao ◽

Anand Km ◽

Gowrish Rao S

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Urine Samples ◽

Automated System ◽

Care Hospital ◽

Pseudomonas Species ◽

Significant Bacteriuria

Objectives: Pseudomonas species cause urinary tract infection (UTI). This study was conducted to isolate Pseudomonas species causing significant bacteriuria and to analyze its antibiogram at a tertiary care hospital.Methods: About 107 urine samples received in the laboratory from August 2015 to July 2016 having significant bacteriuria with Pseudomonas species were tested for antimicrobial activity. Samples were from both inpatients and patients attending as outpatients to a tertiary care hospital with different age groups and gender. Midstream urine samples were inoculated using a standard calibrated loop into blood agar and MacConkey agar following semi quantitative technique using Kass concept. MALD (Biomerio, ElToile, France) was used for speciation, and Vitex automated system (Biomerio, ElToile, France) was used for antibacterial sensitivity testing.Results: About 107 urine samples contained Pseudomonas species by MALDI obtained from 69 male (64.48%) and 38 (35.51%) female patients. Inpatients were 90 (84.11%) and 17 (15.88%) outpatient department (OPD) patients. Isolation of Pseudomonas aeruginosa was from 90 samples (84.11%) and Pseudomonas putida in 17 (15.88%). Significant bacteriuria was more in the age group of ˃60 years in both genders. Susceptibility to gentamicin was 52 (48.59%), ceftazidime 56 (52.33%), and imipenem was 58 (54.20%). Organism was multidrug resistant in 49 (45.79%) samples.Conclusion: P. aeruginosa remains the most common uropathogen among Pseudomonas species. Drug of choice for inpatients suffering from UTI by Pseudomonas species can be gentamicin and for patients attending OPD can be ceftazidime. Imipenem can be the reserve drug. Periodic antibiotic review is required for proper treatment of UTI.

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Bacterial vaginosis and antibacterial susceptibility pattern of asymptomatic urinary tract infection in pregnant women at a tertiary care hospital, Visakhaptn, India

Iranian Journal of Microbiology ◽

10.18502/ijm.v11i6.2220 ◽

2020 ◽

Author(s):

Appikatla Madhu Bhavana ◽

Pilli Hema Prakash Kumari ◽

Nitin Mohan ◽

Vijayalakshmai Chandrasekhar ◽

Payala Vijayalakshmi ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Bacterial Vaginosis ◽

Pregnant Women ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Asymptomatic Bacteriuria ◽

Care Hospital ◽

Posterior Fornix

Background and Objectives: The association between bacterial vaginosis and urinary tract infection (UTI) in pregnant women is at a greater risk comparatively than patients with bacterial vaginosis or UTI. Bacterial vaginosis and asymptomatic UTI both pose risk for mother and fetus. Early diagnosis and treatment can save the life of both. The present investigation was aimed to find out the magnitude of asymptomatic bacteriuria in pregnant women with noticeable bacterial vaginitis at- tending antenatal outpatient and inpatient of a tertiary care hospital and to identify the organisms causing it. Materials and Methods: A total of 117 antenatal women from different age and parity groups with different gestational ages were included in the study. The samples were subjected to standard microbiological techniques for identification of micro- organisms. While performing Per speculum examination, vaginal secretions were collected from the posterior fornix. Swabs from the posterior fornix were tested for pH using litmus paper. A wet mount and Gram smear was made and examined for the presence of bacteria, polymorphs and clue cells indicating bacterial vaginosis. Amsel’s criteria and Nugent scoring sys- tem were applied for diagnosis of bacterial vaginosis. Antibiotic susceptibility of the isolated bacteria was performed using Kirby-Bauer method. Results: Bacterial vaginosis infection rate (62.3%) was common in the present study followed by asymptomatic UTI (n=60, 51%). It was also observed that asymptomatic urinary tract infection (UTI) with Bacterial vaginosis prevalent rate was 49 (41.8%) in the current study. Conclusion: Bacterial vaginosis was more common than asymptomatic bacteriuria in pregnant women. It is recommended that antenatal health care facilities should incorporate screening of vaginitis among pregnant women to prevent the complica- tions of pregnancy. And those women with Bacterial vaginosis should be screened for UTI. Proper use of antibiotics should be encouraged, abuse of antibiotics should be in check.

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A clinical study of uropathogens causing urinary tract infection in children and adolescents in a tertiary care hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20204094 ◽

2020 ◽

Vol 9 (10) ◽

pp. 1549

Author(s):

R. Abisha Rezia ◽

R. Vijendra ◽

Anjana Gopi

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Children And Adolescents ◽

Antimicrobial Susceptibility ◽

Urine Samples ◽

Diffusion Method ◽

Care Hospital ◽

E Coli ◽

The Common

Background: Urinary Tract Infection (UTI) is one of the common infections in children. Incidence varies with age, race and gender. UTIs have become difficult to treat due to development of resistance among uropathogens. Regional data regarding the common uropathogens and their antimicrobial susceptibility pattern is required to guide the clinicians to start empirical therapy while treating UTIs.Aims: This study is aimed to study the profile of uropathogens causing UTI in children and adolescents, assess their antimicrobial susceptibility, the clinical course and outcome.Methods: All subjects with suspected UTI whose urine samples grew a positive culture of uropathogens were included in this prospective observational study. The study was done in the Department of Microbiology from July 2019 to December 2019. The urine samples were processed by standard methods (using 5% sheep blood agar and MacConkey agar) and antimicrobial susceptibility was performed using the Kirby-Bauer disk diffusion method. The details of the pathogens grown, and their antimicrobial sensitivity and resistance patterns were recorded, and the subjects were followed up during their course in the hospital.Results: A total of 109 urine samples from paediatric and adolescent subjects showed positive cultures (97.32%). UTI was common among toddlers (46.7%). E. coli contributed to 40.3% of the cases, followed by Enterococcus and Klebsiella pneumonaie. E. coli was resistant to amoxicillin + clavulanic acid, cephalosporins and ciprofloxacin. The organisms were sensitive to meropenem, amikacin and piperacillin + tazobactam.Conclusion: Incidence of UTI and the uropathogens causing UTI varies with age. Different uropathogens and their resistance to commonly used antimicrobials is a concern for future treatment options in UTI.

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Drug Susceptibility Pattern and Associated Factors of Bacteria Isolated from Urinary Tract Infection among Pregnant Women Attending Antenatal Care in Teaching Hospital, Southeast Ethiopia

10.21203/rs.3.rs-118159/v1 ◽

2021 ◽

Author(s):

Eshetu Nigussie ◽

Meseret Mitiku ◽

Alelign Tasew ◽

Biniyam sahiledengel ◽

Damtew Solomon ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Pregnant Women ◽

Previous History ◽

Urine Samples ◽

P Value ◽

Susceptibility Pattern ◽

Southeast Ethiopia ◽

Significant Bacteriuria

Abstract Background: Urinary tract infection is caused by bacteria from the digestive tract which climbs the opening of the urethra and begins to multiply to cause infection. This study aimed to assess the bacterial profile and antibiotic susceptibility pattern and associated risk factors among pregnant women in Madda Walabu University Goba Referral Hospital, Southeast Ethiopia. Methods: An institution-based cross-sectional study was conducted from June-August, 2019. A total of 234 pregnant women were enrolled; data were collected using a structured questionnaire by a trained interviewer. Urine samples were collected from all pregnant women and culture on cysteine lysine electrolytes deficiency medium. Data were analyzed using SPSS 20.0. Descriptive statistics were used to explain the study participants with relevant variables. Logistic regression was used for data comparison. P-value <0.05 was accepted as statistically significant. Results: The overall prevalence of UTI was 23.9% among both asymptomatic and symptomatic groups. Of this screened midstream urine samples showed that 16% and 32.2%, had significant bacteriuria in the asymptomatic and symptomatic groups respectively. The prevalence of UTI was significantly associated with previous history of catheterization and urinary tract infection. E. coli was the most frequently isolated organism (42.9%) followed by coagulase-negative Staphylococcus (26.8%), and S. aureus (12.5%). Gram-negative and Gram-positive bacteria accounted for (59%) and (41%) respectively.Conclusion: Significant bacteriuria has been observed from both symptomatic and asymptomatic pregnant women. The majority of the isolates were resistant to commonly prescribed antibiotics. This calls for an early screening of all pregnant women for UTI and those found to be infected need treatment.

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Study the Antibiotics Activity Against Escherichia Coli Isolated from Urine Samples of Pregnant Women with Urinary Tract Infection

International Journal of Pharmaceutical Research ◽

10.31838/ijpr/2021.13.01.300 ◽

2020 ◽

Vol 13 (01) ◽

Keyword(s):

Escherichia Coli ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Pregnant Women ◽

Urine Samples

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Prevalence of multidrug resistance (MDR) and extended spectrum beta-lactamases (ESBLs) among uropathogenic Escherichia coli isolates from female patients in a tertiary care hospital in North India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184961 ◽

2018 ◽

Vol 7 (12) ◽

pp. 5031 ◽

Cited By ~ 1

Author(s):

Bhaskar Das ◽

Natasha Mittal ◽

Rajni Goswami ◽

Deepti Adhana ◽

Neha Rathore

Keyword(s):

Escherichia Coli ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urine Samples ◽

Uncomplicated Urinary Tract Infection ◽

Care Hospital ◽

Sensitivity Testing ◽

Esbl Producer ◽

Female Patients

Background: Urinary tract infection (UTI) is a common bacterial infection in women. It is very common during pregnancy and may present as asymptomatic bacteriuria. Escherichia coli is the primary urinary pathogen accounting for 74-90% of uncomplicated urinary tract infection. The aim of the study was to evaluate in-vitro antibiotic susceptibility among urine isolates of Escherichia coli and prevalence of resistance marker like ESBL producer and MDR status.Methods: Mid-stream urine samples of 205 female patients were processed for culture and sensitivity. All the samples were inoculated on culture media and growth showing significant bacteriuria (>105 cfu/ml) were subjected to identification and antibiotic sensitivity testing on Automated system BD Phoenix 100. ESBL status was detected by the system and MDR status was evaluated by standard guidelines.Results: Out of 205 urine samples, 47 samples (22.93%) showed growth of organism. Out of the 47 growth positive samples, 36 (76.60%) samples showed growth of Escherichia coli and out of which 13 (36.11%) were ESBL producer and 23 (63.89%) were ESBL non-producer. Escherichia coli was mostly isolated from younger age group (21-40 years) (61.11%). Antimicrobial susceptibility showed very good sensitivity towards Amikacin, Tigecycline, Carbapenems, Fosfomycin, Piperacillin-tazobactam and Nitrofurantoin. All the isolates of ESBL producer are MDR (100%) and 21.7% of ESBL non-producer are MDR. There is evidence of transfer of resistance genes for non-β-lactam antibiotics along with ESBL resistance marker.Conclusions: Escherichia coli was the predominant uropathogen isolated from female patients and Amikacin, Nitrofurantoin and Fosfomycin can be used as first line drug.

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MICROBIOLOGICAL SCREENING AND DETERMINATION OF ANTIBIOTIC RESISTANCE OF THE UROPATHOGEN ESCHERICHIA COLI IN PREGNANT WOMEN IN THE CLINIC OF THE ALMATY СITY HOSPITAL №7

Vestnik ◽

10.53065/kaznmu.2021.83.12.014 ◽

2021 ◽

pp. 75-80

Author(s):

В.Н. Сон ◽

М.Р. Рысулы ◽

С.Т. Турсыналиев ◽

М.Е. Рамазанов

Keyword(s):

Escherichia Coli ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Pregnant Women ◽

Asymptomatic Bacteriuria ◽

E Coli ◽

Screening Programs ◽

Susceptibility Study

Бессимптомная бактериурия определяется как присутствие бактерий в моче беременных без признаков или симптомов инфекции мочевыводящих путей (ИМП). Стандартное микробиологическое исследование образцов мочи проведено с июня 2019 года по декабрь 2020 года у 800 беременных по программам скрининга на наличие мочеполовой инфекции (ИМП) в поликлинике городской клинической больницы №7 г.Алматы. Образцы были протестированы микробиологически по стандартным методикам, рекомендованных CAESAR. Выбор антимикробных препаратов (АМП) для включения в исследование чувствительности, а также принципы интерпретации результатов проводились согласно рекомендации Европейского комитета по определению чувствительности к антибиотикам (EUCAST). Представлены результаты оценки резистенности и чувствительности к антимикробным препаратам 138 клинических изолятов Escherichia coli, выделенных из образцов мочи беременных пациенток поликлиники №35 ГКБ №7 УОЗ г.Алматы. Основными уропатогеном в 66,3% являются E. Coli, меньше - в 15,9% Staphylococcus aureus и в 8,2% Klebsiella pneumoniae. Чувствительность изолятов Escherihia coli была для левофлоксацина (76,6%), комбинации пиперациллин/тазобактаму (73,7%), ципрофлоксацину (71,5%), тетрациклину (74,4%), но низкой для пиперациллина (24.8%), цефураксима (38,6%), тобрамицина (40,9%), цефазилина (40,1%), цефепима (40,1%); цефтазидима (43%), комбинации триметоприм/сульфаметаксазол (43,8%). Чувствительность E. coli к карбапенемам - для имипенема (73%), меропенема (67,8%), эртапенема (76,6%), а устойчивость составляла для эртапенема (13,8%), меропенема (16%) и имипенема (3,6%). Asymptomatic bacteriuria is defined as the presence of bacteria in the urine of pregnant women without signs or symptoms of a urinary tract infection (UTI). A standard microbiological study of urine samples was carried out from June 2019 to December 2020 in 800 pregnant women under screening programs for the presence of urinary tract infection (UTI) in the ambulatory of the Almaty city clinical hospital № 7. The samples were tested microbiologically according to standard methods recommended by CAESAR. The choice of AMPs for inclusion in the susceptibility study, as well as the principles of interpretation of the results, were carried out according to the recommendation of the European Committee for the determination of antibiotic susceptibility (EUCAST). The sensitivity of Escherihia coli isolates was for levofloxacin (76.6%), piperacillin / tazobactam combination (73.7%), ciprofloxacin (71.5%), tetracycline (74.4%), but low for piperacillin (24.8%), cefuraxime (38.6%), tobramycin (40.9%), cefazilin (40.1%), cefepime (40.1%); ceftazidime (43%), trimethoprim / sulfametaxazole combination (43.8%). The sensitivity of Escherihia coli to carbapenems was for imipenem (73%), meropenem (67.8%), ertapenem (76.6%), and resistance was for ertapenem (13.8%), meropenem (16%) and imipenem (3,6%).

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