Prevalence Of Asymptomatic Bacteriuria And Antimicrobial Susceptibility Among Women Attending Antenatal Clinic Of Gatundu Hospital In Kiambu County, Kenya

ABSTRACT

Asymptomatic bacteriuria in pregnancy is associated with risk of preterm birth and pyelonephritis if untreated. The apparent decline in immunity of pregnant women appears to promote the growth of both commensal and non-commensal microorganisms. Women with asymptomatic bacteria in the early pregnancy develop symptomatic bacteriuria later in pregnancy. The incidence of antibiotic resistance has been steadily increasing over the past few years resulting in limitation of therapeutic options. The aim of this study was to identify the prevalence of asymptomatic bacteriuria, the most common causative microorganisms and the antibacterial susceptibilities of the isolated microorganisms in pregnant women attending antenatal clinic at Gatundu Level Four hospital. An analytical cross sectional study design was applied to women with asymptomatic bacteriuria who attended the antenatal clinic and utilized the laboratory services. Quantitative data was analyzed using a computer package IBM SPSS statistics 20.0 by invoking the analysis of descriptive statistics and focusing on frequencies and percentages. Pearson Chi square test was carried out where p< 0.05 values were considered significant. A total number of 120 asymptomatic pregnant women were screened for ASB by urine culture using a semi quantitative culture method. Midstream urine was collected and aerobically incubated at 37° C on CLED and MacConkey Agar. Growth of >1x105 CFU/mL was taken as significant bacteriuria. Gram-negative bacteria were identified and confirmed by biochemical tests. In this study, the prevalence of bacteriuria among the pregnant women was 10.8 %. The prevalences of isolated bacteria from urines of pregnant women were: Escherichia coli 69.2 %, Proteus species 23.1 % and Klebsiella species 7.7 %. Among cases which showed positive cultures, 10.0 % were nulliparous and 11.4 % were multiparous. The highest incidence (33.3 %) of asymptomatic bacteriuria was found in the maternal age category age group of 31-35 years. Majority of the isolates in the study were susceptible to Cefataxime (100 %) Ofloxacin (88.9 %) and Gentamycin (44.4 %). Findings of the study provide empirical data on the prevalence of asymptomatic bacteriuria within pregnant women. The prevalence of asymptomatic bacteriuria is high among this study population, therefore all pregnant women should be screened during their first visit to ante-natal clinic by urine culture to detect and treat ASB to avoid complications that may ensue in both mother and fetus. Establishment of antibiotic policy to guide against the emergence of resistant organisms that cause asymptomatic bacteriuria should be effected.