Abstract
Urinary Tract Infections (UTIs) during pregnancy are among the most common infections worldwide and can lead to poor perinatal and maternal outcomes. This study determined the prevalence of UTIs during pregnancy, associated risk factors and antimicrobial susceptibility profiles of associated bacterial pathogens. A cross-sectional study was conducted among 210 pregnant women attending antenatal clinic at Pumwani Maternity hospital. Their social-demographic profiles were obtained using a structured questionnaire. Cultures were done from midstream urine and antimicrobial susceptibility testing determined using the disc diffusion test. The overall prevalence of UTI was 15.7% regardless of the women’s age, parity and stage of gestation. Prevalence of asymptomatic and symptomatic bacteriuria was 4.3% and 11.4% respectively. Material of undergarment and frequency of changing the undergarments were found to contribute significantly to the acquisition of UTI (P < 0.05). E. coli was the most predominant UTI organism at (44.5%) followed by K. pneumoniae (21.2%) and S. aureus (15.1%). Almost a half (over 49%) of all Gram-negative organisms showed resistance prevalence against third generation cephalosporins, fluoroquinolones, Sulfamethoxazole-Trimethoprim, Cefoxitin, Nitrofurantoin and Amoxicillin-clavulanic acid. Gram-positive strains were susceptible to Amoxicillin-clavulanic acid, Nitrofurantoin, Linezolid and Ofloxacin. The prevalence of multi-drug resistance (MDR) in all study isolates was 96%. Our data suggest a serious resistance trend among UTI strains and more should be done to slow down this trend. Pregnant women should be screened by urine culture and treatment be guided by the antimicrobial susceptibility data.
Highlights
In developing countries, Urinary Tract Infections (UTIs) are among the most common health problems affecting women in their reproductive ages
The incidence of acute pyelonephritis in pregnant women is significantly increased [2]. Factors such as history of recurrent urinary tract infection, diabetes, low social economic status, increasing maternal age, multiparity, and anatomical abnormalities of the urinary tract have been associated with a two fold increase in bacteriuria during pregnancy [2], but the risk factors associated with UTIs in Africa remains poorly investigated
Pregnant mothers in the age group of 21 - years had the highest prevalence of UTI at 75.8% followed by those aged - 40 years at 12.1%, below 20 years of age at 9.1% while those above the age of 40 years had the least prevalence of 3%
Summary
UTIs are among the most common health problems affecting women in their reproductive ages. The incidence of acute pyelonephritis in pregnant women is significantly increased [2] Factors such as history of recurrent urinary tract infection, diabetes, low social economic status, increasing maternal age, multiparity, and anatomical abnormalities of the urinary tract have been associated with a two fold increase in bacteriuria during pregnancy [2], but the risk factors associated with UTIs in Africa remains poorly investigated. Past studies indicate that UTI among pregnant mothers in Kenya range from 10% - 19% [6]. Most of these studies concentrate on selected bacterial pathogens and the larger spectrum of bacterial etiologic agents remains unknown. The socio-demographic and lifestyle factors associated with UTIs among pregnant women in Kenya remain uninvestigated
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