Abstract

Asymptomatic bacteriuria is the presence of multiplying bacteria in the absence of any symptoms. The relevance of ASB lies in the insight it provides into symptomatic infections. Physiological and anatomical alterations during pregnancy make women more predisposed to urinary tract infection. This study seeks to determine the prevalence, risk factors, and bacteria profile among pregnant and non-pregnant women. A total of 230 pregnant women and 100 age-matched non-pregnant women were recruited. All pregnant women were recruited from individuals attending antenatal clinic and the controls recruited within the same hospital. Clean catch mid-stream urines ample was collected and microbial analysis done immediately. Significant ASB was identified and antibiotic sensitivity determined by conventional protocols. The overall prevalence of ASB in this study was 29.1% and 15% among pregnant and non-pregnant women respectively. The mean age was 25.3±5.2 and 24.2±5.6years for pregnant and non-pregnant women. Based on their parity among pregnant women, 112 (48.7%), 61(26.5%) and 57 (24.8%) were nulliparous, monoparous and multiparous respectively. Also, 37(16.1%), 70(30.4%) and 123(53.5%) of the pregnant women were in the 1<sup>st</sup>, 2<sup>nd</sup> and 3<sup>rd</sup> trimester. Sixty-seven (29.1%), 125 (54.3%) and 37 (16.1%) pregnant subjects were housewives, self-employed and civil servants in their occupation. Trimester was a risk factor for asymptomatic bacteriuria in the 2nd and 3rd trimester. There was association between age, parity, trimester and ASB. The most common isolate in this study was <i>Escherichia coli</i> (28.4%), followed by <i>Klebsiella pneumonia</i> (23.9%). The <i>Escherichia coli</i> and other uropathogens isolates were multiple drug sensitive between 50-100%. Previous bacteriuria treatment seeking pattern among the pregnant women was 138(60%), 42(18.3%), 32(13.9%) and 1(0.4%) for individuals who had sought treatments in hospitals, patent drug dealers (chemists), multi-centres and traditionally respectively. It is recommended that routine urine culture screening be conducted for all pregnant women at least in the second and third trimesters and positive ASB promptly treated.

Highlights

  • Urinary tract infection (UTI) is one of the commonest health problems among women due to shorter urethra, pathogens entry facilitated by sexual intercourse and close proximity of the anus with vagina [1,2,3,4]

  • Asymptomatic bacteriuria is defined as the presence of significant bacteria (≥105Cfu/ml) in two consecutive clean-voided mid-stream urine specimen in a patient without signs or symptoms according to Gessese et al, [16]

  • This study have provided current asymptomatic bacterial profile, prevalence and associated risk factors among pregnant and non-pregnant women in a peri-urban area (Anua, Offot Ukwa district), Akwa-Ibom state

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Summary

Introduction

Urinary tract infection (UTI) is one of the commonest health problems among women due to shorter urethra, pathogens entry facilitated by sexual intercourse and close proximity of the anus with vagina [1,2,3,4]. Gestational glycosuria, proteinuria and elevated levels of progesterone can decrease the muscle tone of the ureter and bladder It can result in vesico-ureteric reflux [7]. Lower tract bacterial infection is associated with an increased risk of developing pyelonephritis in pregnancy, which is linked to adverse maternal and obstetric outcomes [8]. Untreated ASB is a risk factor for acute cystitis up to 40% and pyelonephritis (between 25-30%) in pregnant women in some populations; and could lead to adverse obstetric and maternal outcomes like prematurity, low-birth weight, abnormalities in babies, and higher fetal mortality rates in several documented researches [11,12,13]. This study seeks to investigate the prevalence, risk factors, and asymptomatic uropathogenic bacteria profile among participants visiting St Luke’s Hospital Anua, Offot Ukwa district using a casecontrol approach

Study Design
Ethical Considerations and Participants Recruitment
Inclusion and Exclusion Criteria
Sample Collection
Microbiological Examination of the Samples
Biochemical Testing
Statistical Analysis
Socio-demographic Variables of Participants
Prevalence of ASB Uropathogens and the Presence of Abnormal Conditions
Isolation and Identification of ASB Uropathogens
Antimicrobial Susceptibility Pattern of ASB Uropathogens
Discussions
Conclusions
Full Text
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