High prevalence of antibiotic resistance among bacteria isolated from pregnant women with asymptomatic urinary tract infections in Dar es Salaam,Tanzania
Objectives: Urinary tract infections (UTI) are among the major causes of morbidity in pregnant women because of physiological changes during pregnancy and, if unattended to may cause severe complications to mother and foetus. Asymptomatic urinary tract infections (AUTI) can be important predictors for pathogenesis of UTI. This study aimed to determine the prevalence of AUTI among pregnant women using rapid dipstick and routine culture methods to assess antimicrobial resistance patterns of isolated pathogens.
Methods: This was a cross-sectional study. Using non-probability convenience sampling technique, a total of 202 pregnant women attending Antinatal Care (ANC) were recruited. Mid-stream urine was collected and subjected to rapid dipstick and urine culture media. Antibacterial susceptibility tests were conducted against the bacteria. Risk factors for AUTI and demographic data were obtained using pretested questionnaire. Data were analyzed using SPSS Vs. 20 software package.
Results: Of the 202 pregnant women, 47 (23.3%) had AUTI. Age ranged from 15-45 years with a median of 26±3.0 years. The main uropathogens were Escherichia coli (E.coli) 22(46.8%). The dipstick test had sensitivity of 79.2% and specificity of 63.6%. Seventy-three percent of E. coli were resistant to ampicillin and 86% to erythromycin. The prevalence rate of antibiotic resistance among the isolated bacteria ranged from 73 to100%.
Conclusion: Prevalent uropathogens among bacteria isolated from pregnant women with AUTI were Escherichia coli and Klebsiella pneumoniae. High antibiotic resistance were observed among the bacteria. About 23% of pregnant women had AUTI. We advocate for regular culture of urine to be performed because of the lower sensitivity of dipstick test.
Keywords: Pregnancy, antibiotic resistance, uropathogenic bacteria