Asymptomatic Bacteriuria in pregnant women attending antenatal clinic in a tertiary hospital in Abuja, Nigeria
Context: Asymptomatic bacteriuria (ASB) predisposes to cystitis and pyelonephritis. In pregnancy it is associated with maternal morbidity and adverse perinatal outcomes. A wide range of prevalence has been reported in the literature. Efforts to improve maternal and perinatal outcomes have led to the recommendation of routine antenatal screening and treatment of clients with ASB.
Objective: To determine the prevalence of ASB, the microbial isolates and antibiotic sensitivity among antenatal clients in the National Hospital Abuja.
Patients and Methods: It was a cross sectional study of pregnant women presenting for the first antenatal clinic visit at the National Hospital Abuja. One hundred and forty six pregnant women who met the inclusion criteria and gave consent were interviewed, relevant demographic and clinical characteristics were obtained and clean catch, mid stream urine samples were collected and processed using standard bacteriological methods.
Results: Significant bacteriuria (colony-forming unit ≥ 105/ml) was found in 67 (45.9%) of the 146 pregnant women tested. There was no significant difference in prevalence of ASB with respect to age (p=0.245), parity (p=0.607), occupation (p=0.172) and pregnancy trimesters (p=0.459). Staphylococcus aureus was the most common causative organism found in 24(35.8%) cases followed by Escherichia coli in 19 (28.36%) and Klebsiella species in 14 (20.9%) cases. The susceptibility rate of bacterial isolate was highest for levofloxacin (83.6%), followed by nalidixic acid (64.2%) and nitrofurantoin (62.7%). The pathogens were least susceptible to co-trimoxazole (8.3%), ampilcillin (8.8%) and amoxicillin (10.4%)
Conclusion: The prevalence of asymptomatic bacteria among the pregnant women was high. The isolated organisms were resistant to many antibiotics commonly used in the management of urinary tract infection. The practice of routine urine culture for antenatal screening for asymptomatic bacteriuria will be beneficial in our setting.
Keywords: Asymptomatic bacteriuria, antibiotic sensitivity, microbial isolates, pregnant women, urinary tract infection
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