scholarly journals Screening and Analysis of Asymptomatic Bacteriuria during Pregnancy

2016 ◽  
Vol 8 (3) ◽  
pp. 171-174
Author(s):  
Zahra Hoodbhoy ◽  
Arshia Javed ◽  
Aisha S Wali

ABSTRACT Aim Asymptomatic bacteriuria (ASB) is a common condition in pregnancy. The aim of our study is to estimate the rate of ASB, causative organisms, and antibiotic sensitivity in a secondary care hospital. Materials and methods Midstream clean catch urinary sample was collected from 149 women between 12 and 28 weeks of gestation. Those with urinary symptoms, diagnosed for urinary tract infection (UTI), with vaginal bleeding or vaginal discharge, and who had given antibiotics within 7 days preceding sample collection were excluded. Data were collected from medical records, and statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 19. Results Asymptomatic bacteriuria was seen in 26% (n = 39) of the women. No association of age, parity, gestational age, body mass index (BMI), and diabetes was found with ASB. The most common pathogen isolated was Escherichia coli (46%) followed by Streptococcus (17.9%) and Staphylococcus aureus (10.3%). Fosfomycin with 94.4% sensitivity and nitrofurantoin with 89% sensitivity were seen as first- and second-line antibiotics for treatment of E. coli. Overall sensitivity of all isolates was 69.20% for fosfomycin, 66.6% for ceftriaxone, and 61% for augmentin. The three most common antibiotics (i.e., penicillin, pipemidic acid, and ampicillin) used in pregnancy showed highest overall resistance for all isolates. Conclusion Incidence of ASB was significantly high. The most common bacteria isolated was E. coli. Clinical significance Due to large variance in prevalence worldwide, incidences should be studied in local population and antibiotics should be prescribed according to culture and sensitivity to address the issue of multidrug resistance. How to cite this article Javed A, Wali AS, Hoodbhoy Z. Screening and Analysis of Asymptomatic Bacteriuria during Pregnancy. J South Asian Feder Obst Gynae 2016;8(3):171-174.

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.


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Anne CC Lee ◽  
Luke C. Mullany ◽  
Alain K. Koffi ◽  
Iftekhar Rafiqullah ◽  
Rasheda Khanam ◽  
...  

Abstract Background Urinary tract infection (UTI) in pregnancy, including asymptomatic bacteriuria, is associated with maternal morbidity and adverse pregnancy outcomes, including preterm birth and low birthweight. In low-middle income countries (LMICs), the capacity for screening and treatment of UTIs is limited. The objective of this study was to describe the population-based prevalence, risk factors, etiology and antimicrobial resistance patterns of UTIs in pregnancy in Bangladesh. Methods In a community-based cohort in Sylhet district, Bangladesh, urine specimens were collected at the household level in 4242 pregnant women (< 20 weeks gestation) for culture and antibiotic susceptibility testing. Basic descriptive analysis was performed, as well as logistic regression to calculate adjusted odds ratios (aOR) for UTI risk factors. Results The prevalence of UTI was 8.9% (4.4% symptomatic UTI, 4.5% asymptomatic bacteriuria). Risk factors for UTI in this population included maternal undernutrition (mid-upper arm circumference <23 cm: aOR= 1.29, 95% CI: 1.03–1.61), primiparity (aOR= 1.45, 95% CI: 1.15–1.84), and low paternal education (no education: aOR= 1.56, 95% CI: 1.09–2.22). The predominant uro-pathogens were E. coli (38% of isolates), Klebsiella (12%), and staphyloccocal species (23%). Group B streptococcus accounted for 5.3% of uro-pathogens. Rates of antibiotic resistance were high, with only two-thirds of E. coli susceptible to 3rd generation cephalosporins. Conclusions In Sylhet, Bangladesh, one in 11 women had a UTI in pregnancy, and approximately half of cases were asymptomatic. There is a need for low-cost and accurate methods for UTI screening in pregnancy and efforts to address increasing rates of antibiotic resistance in LMIC.


2017 ◽  
Vol 7 (2) ◽  
pp. 101-105
Author(s):  
Jamal Uddin Ahmed ◽  
Mohammad Delwar Hossain ◽  
Muhammad Abdur Rahim ◽  
Farhana Afroz ◽  
AKM Musa

Background: Diabetes mellitus (DM) is an immunosuppressive condition and uncontrolled diabetes is associated with increased susceptibility to various infections like pneumonia. Community acquired pneumonia (CAP) in diabetic patients is often caused by more virulent or atypical organisms and associated with increased resistance to conventional antibiotics. The aims of this study were to identify the bacterial etiology of CAP in patients with DM and to see their antibiotic sensitivity pattern.Methods: This was a cross-sectional, observational study conducted in the Department of Internal Medicine & Pulmonology of BIRDEM General Hospital, Dhaka, Bangladesh, from January 2013 to December 2015. A total of 120 hospitalized diabetic patients diagnosed with CAP and with a positive sputum culture growth of any bacteria were included in the study.Results: Majority (67%) of the patients were male. Mean age of the patients was - 55.69 ±10.5 years. Mean duration of diabetes was - 7.35 ±1.3 years. Mean HbA1c was - 8.6 ±1.89%. Sputum for culture showed that out of 120 (100%) patients, Klebsiella pneumoniae was detected in 53 (44.2%) patients, Staphylococcus aureus in 18 (15.0%), Pseudomonas species in 16 (13.3%) patients, Acinetobacter in 10 (8.3%), Escherichia coli in 9 (7.5%) patients and 14 (11.7%) patients had growth of other organisms. Sensitivity pattern of different bacterial growth in sputum to commonly used antibiotics like ceftriaxone, ciprofloxacin, amikacin and imipenem were as follows – Klebsiella (19%, 47%, 74%, 96% respectively), Staph aureus (11%, 33%, 78%, 67% respectively), Pseudomonas (19%, 75%, 81%, 88% respectively), Acinetobacter (0%, 0%, 20%, 50% respectively), E. coli (22%, 22%, 100%, 100% respectively). All (100%) of the Pseudomonas and Acinetobacter were sensitive to colistin. Most of the growth of all the bacteria (Klebsiella 94%, Staphylococcus 78%, Pseudomonas 81%, Acinetobacter 100%, E. coli 100%) occurred in patients with poor glycemic control (HbA1c ? 7.0%).Conclusion: This study results suggest that CAP in diabetic patients are more frequently due to Klebsiella pneumoniae, Staphylococcus aureus and Pseudomonas species and mostly they are less sensitive to commonly used antibiotics like ceftriaxone and ciprofloxacin. So, whenever possible, treatment of CAP should be guided by sputum culture and sensitivity test and for empirical treatment of CAP in diabetic patients, alternative antibiotics like imipenem and amikacin should be considered.Birdem Med J 2017; 7(2): 101-105


2017 ◽  
Vol 4 (6) ◽  
pp. 2103
Author(s):  
Rekha Thaddanee ◽  
Gurudas Khilnani ◽  
Nupur Shah ◽  
Ajeet Kumar Khilnani

Background: This prospective observational study was conducted in a tertiary care hospital in Kachchh, over a period of 6 months, to know the antibiotic sensitivity pattern of pathogens in children less than 18 years old with Urinary Tract Infection (UTI).Methods: Between December 2016 to June 2017, 186 children met the inclusion criterion. Urine samples were collected and processed for urine routine microscopy, culture and antibiotic sensitivity as per the standard laboratory guidelines. Urine culture was positive in 50 cases, which were further evaluated to find out any renal disease. All patients were given 10-14 days antibiotics course and follow-up urine reports were done. Patients were considered cured when the follow-up urine reports were normal.Results: E. coli was the commonest organism (34%) isolated, found mainly in 1-5 years age group (20%). Enterococci were isolated in 32% cases, most of which were less than 5 years of age (28%). Klebsiella (12%), Methicillin Resistant Staphylococcus Aureus (MRSA) (10%), Coagulase negative staphylococci (6%), Pseudomonas (2%) and Budding yeast cell (4%) were the less frequent organisms isolated. E. coli were found to be less sensitive to different Aminoglycosides (11.7% - 23.5%), Cephalosporins (11.7% - 52.9%), Fluoroquinolones (5.8% - 11.7%), Co-trimoxazole (17.6%) and Piperacillin (17.6%), but were more sensitive (70.6%) to Imipenems. Enterococci were also partially sensitive to Aminoglycosides (6.2-18.7%), Cephalosporins (25-37.5.7%), Fluoroquinolones (6.25-12.5%), Penicillin-G (50%), Piperacillin (31.25%) and Co-trimoxazole (43.75%), but had good sensitivity for Imipenems (68.7%), Linezolid (75%) and Vancomycin (81.2%). Similarly, MRSA was 100% sensitive to Linezolid and Imipenem but partially sensitive (20-60%) to other antibiotics. Klebsiella showed 16.65-33.3% sensitivity to all antibiotics except Imipenem (83.3%) and was 100% resistant to Co-trimoxazole. Coagulase negative Staphylococci (CONS) remained 100% sensitive to all antibiotics and Pseudomonas was resistant to all antibiotics.Conclusions: The study concludes that pathogens for UTI in children have developed resistance, even to the newer generation antibiotics, probably due to the irrational use of antibiotics. In view of emergence of multi drug resistant pathogens, which carry considerable morbidity and mortality, every effort must be taken to use antibiotics judiciously.


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):  
Priya Paari ◽  
Sindhuja T. P. ◽  
Shanthi Dhinakaran ◽  
Christina Mary P. Paul

Background: Asymptomatic bacteriuria (ASB) in pregnancy is a treatable risk factor for preterm delivery. India accounts for the highest preterm birth incidence in the world according to the WHO census released in November 2016. This study was aimed at finding the prevalence of asymptomatic bacteriuria, the spectrum of bacteria involved and the susceptibility pattern for the antimicrobials in the antenatal women attending a tertiary care hospital in urban Southern India.Methods: One hundred and eighty ante-natal patients without symptoms of ongoing urinary tract infection were enrolled to this study. Clean midstream urine sample was collected in a wide mouthed container and sample was analyzed by standardized microbiological testing techniques.Results: Out of the 180 ante-natal women included in the study, 11(6.1%) patients were found to have insignificant bacteriuria and 38(21.1%) had a significant bacteriuria. E. coli was the most frequently isolated organism and about 95% of the organisms were sensitive to Nitrofurantoin.Conclusions: More than a fifth of all pregnant women have ASB and E. coli is the most frequent pathogen encountered.


2016 ◽  
Vol 5 (1) ◽  
pp. 20-23
Author(s):  
Raziur Rahman ◽  
Muhammad Abdur Rahim ◽  
Samira Rahat Afroze ◽  
Palash Mitra ◽  
Tabassum Samad ◽  
...  

Background and Aims: Urinary tract infection (UTI) is a common illness. The spectrum of bacteria causing UTI and their antibiotic sensitivity is not uniform. This study was designed to describe the bacteriological spectrum causing UTI and their antibiotic sensitivity.Methods: This cross-sectional study was done in the Department of Internal Medicine, BIRDEM General Hospital from January to June, 2013.Results: Total number of patients was 103 with females predominance (F:M ratio 2:1). Mean age was 57.5 years. Most (91.3%) of the study population were diabetic with poor glycaemic control (mean HbA1c 9.9%). Common symptoms were fever, dysuria, increased urinary frequency, suprapubic pain, vomiting and loin pain. Neutrophilic leukocytosis was common (94.2%). E. coli (79.6%) was the commonest aetiological agent followed by Klebsiella (9.7%), Citrobacter (3.9%), Acinetobacter (1.9%), Enterobacter (1.9%), Enterococcus (1.9%) and Pseudomonas (0.9%). Imipenem (100%), aminoglycosides e.g. amikacin and gentamycin and nitrofurantoin were among the most sensitive antibiotics.Conclusion: E. coli is the commonest organism causing UTI and imipenem, amikacin and nitrofurantoin are the most sensitive antibiotics.Birdem Med J 2015; 5(1): 20-23


2020 ◽  
Vol 7 (1) ◽  
pp. 23-29
Author(s):  
Gunjal P. N. ◽  
Gunjal S. P.

Urinary tract infection (UTI), is defined as a disease caused by invasion of urinary tract by microorganisms. Majority of UTI cases are due to bacterial infection constitute about 95% of total UTI cases. About 80% of UTI cases are caused by E.coli producing extended spectrum ?-lactamase (ESBL) producing isolates. In recent years limitations in treating infections caused by multidrug resistant organisms has increased. This study aims to determine ESBL production of E. coli cases from a tertiary care hospital. Methodology: A total 358 midstream urine samples were collected by random sampling method during March 2015 to June 2018. Identification, antibiotic sensitivity testing, performed according to standard protocol following Clinical and Laboratory Standard Institute (CLSI) guidelines, 2013. Screening for ESBL producing E.coli isolates performed using ceftazidime further confirmation done by phenotypic disc diffusion test using combined disc method using ceftazidime (30µg) & ceftazidime/ clavulanic acid (30/10 µg) as per CLSI guidelines. Results: Total 358 specimens processed for urine culture. Gram negative bacilli isolated from 123(34.35 %), out of which 68 (55.28%) were E.coli, 19 (15.44%) K. pneumoniae, 15 (12.19%), Pseudomonas spp. 08 (6.50%), Citrobacter spp and Acinetobacter spp, 03 (2.43%), Proteus mirabilis, 01 (0.81%) Proteus vulgaris and Enterobacter respectively. Out of 68 isolates of E.coli, 65 (95.58%) were MDR, ESBL was detected in 31 (47.69%) out of these 65 isolates. Out of these 31 cases 19 (61.29%) were female and 12 (38.70%) were male cases. Conclusion: This study concludes 47.69% ESBL producing MDR E. coli were isolated from UTI cases with female predominance.


Author(s):  
Anu Mary Bose ◽  
Sreekumary P. K. ◽  
Sobha Kurian Pulikkottil

Background: Asymptomatic bacteriuria is the presence of actively multiplying bacteria within the urinary tract in the absence of any symptoms. Anatomical and physiological changes make women more susceptible to UTI in pregnancy. The objective of present study was to determine the percentage of pregnant women with asymptomatic bacteriuria and its microbiological profile.Methods: A total of 555 antenatal women who had no clinical features of urinary tract infection were recruited for this study over a period of one year. Clean catch mid-stream urine sample was collected and semi quantitatively cultured immediately. Significant bacteriuria was identified and antibiotic sensitivity found out by conventional methods.Results: Significant growth was observed in 26 samples. There was no association between age, parity, gravidity, period of gestation and asymptomatic bacteriuria. Gram stain was found to be the best screening test. Escherichia coli were the commonest organism isolated. Escherichia coli and Staphylococcus saprophyticus were the most resistant organisms.Conclusions: Escherichia coli, the most common organism isolated, was resistant to most of the commonly used antibiotics. Wet film examination, the most commonly used screening test in our set up, was less sensitive and specific. So culture has to be done in all antenatal cases for screening asymptomatic bacteriuria of pregnancy.


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