Asymptomatic Bacteriuria and their Antimicrobial Susceptibility Pattern Among Pregnant Women Attending Antenatal Clinics at Mizan Aman Town, Southwestern Ethiopia

Abstract

Introduction: Failure to identify asymptomatic bacteriuria (ASB) is responsible for its improper clinical management. This may lead to severe health complications during pregnancy. However, little is known about antimicrobial susceptibility of ASB in Ethiopian pregnant women. Therefore, the study was conducted to assess the prevalence of ASB and its antimicrobial susceptibility pattern in the target population. Methods: A cross-sectional study was conducted during September-December of 2017 at Mizan-Aman town, south-western Ethiopia among pregnant women (n=260) attending antenatal clinics. 10ml of clean- catch midstream urine was collected and cultured on Cysteine Lactose Electrolyte Deficient agar. Bacterial isolates were identified using Gram staining, colony morphology, and biochemical analysis. Antibiotic susceptibility was assessed by Kirby-Bauer disc-diffusion method. Logistic regression was employed for association analysis. Results: The prevalence of urinary tract infection was 10.3%. ASB was significantly associated with second trimester (AOR=5.61 [1.40-22.45]; p<0.05) and history of urinary tract infection (AOR=12.47 [3.91-39.82]; p<0.001). Escherichia coli were most prevalent pathogen and gram positive bacteria comprised majority of the overall isolates (63%). The Gram-negatives were more resistant with susceptibility rates of 11.8%, 29.4%, and 35.3% for ampicillin, nalidixic acid and chloramphenicol respectively. The susceptibility rates of Gram-positives were 100%, 80%, 70% for ciprofloxacin and kanamycin, co-trimoxazol and ceftriaxone and gentamycin respectively. Multidrug resistance (≥2 drugs) was seen in 81.5% of isolates. Conclusion: In generally, pregnant women with ASB may have serious consequences on both mother and fetus. Since in this study the locale specific heterogeneity in ASB prevalence, type and number of bacterial species, dominant bacterial species, antibiotic susceptibility pattern and multidrug resistance was observed. Therefore, it is important to screen all antenatal women for asymptomatic bacteriuria at their first prenatal visit; preferably in first trimester as well as antimicrobial susceptibility testing should be performed for management of ASB among pregnant women.