Asymptomatic bacteriuria of pregnancy in Ibadan, Nigeria: a re-assessment

Abstract

Asymptomatic bacteriuria in pregnancy is the major risk factor for developing symptomatic urinary tract infection during pregnancy. In the present study, 300 pregnant women are screened for significant asymptomatic bacteriuria in order to provide an insight into the prevalence in developing countries, reassessment of some predisposing factors and aetiological agents and their susceptibility tests. The mean age of the patients in the study is 26.8 years (SD: 5.8 years, range: 16–40 years). Using 103 organisms/mL as a significant level of bacteriuria, the prevalence was found to be 21.0%. One hundred and fifty-eight samples had no pus cells with 25 showing significant bacteriuria, 116 samples contained 1–4 pus cells/high power field (hpf) with 25 showing significant bacteriuria, while 26 samples had ≥5 pus cells/hpf with 13 showing significant bacteriuria. There was no particular trend associated with age and rate of infection. However, there was a decline in the rate of infection in the 26–30 age group, with a sharp increase as age increased. There was high incidence of bacteriuria during the third trimester of pregnancy (21.9%) compared with that in the first trimester (7.7%), while the level in the second trimester was 22.5%. Multiparity is associated with increased bacteriuria in pregnancy. Thirty-one (49.2%) isolates grew Gram-negative bacilli; 27 (42.9%) grewGram-positive cocci and the remainder (7.9%) grew yeast-like cells. Staphylococcus aureus was the most frequent pathogen (41.3%), followed by Klebsiella species (33.3%) and Escherichia coli (11.1%). Bacterial isolates from this study were most sensitive to ceftazidime, followed by ceftriazone, and least susceptible to co-trimoxazole.