Abstract
Background: Urinary tract infection (UTI) is a commonly encountered health problem among pregnant women. Untreated UTI may result in fetal complications like preterm birth, low birth weight, intra uterine growth retardation and intrauterine fetal death. One of the major problems with bacterial pathogens is their ability to develop drug resistance. Determining drug susceptibility pattern of bacteria from urinary tract helps to identify effective drugs and minimize further adverse perinatal outcomes. The purpose of this study was to describe the magnitude and drug resistance profile of pregnant women and related fetal outcomes. Methods:A cross-sectional study was conducted from March to June 2019. Socio-demographic data of the study participants was collected by administering structured questionnaire after obtaining full consent of the participants. Clean catch mid-stream urine was collected from the study participants and the samples were transported to the laboratory with screw-capped container. Blood and MacConkey agar were used to cultivate bacteria from urine sample. Bacterial colonies were isolated and identified using standard biochemical properties. Antibacterial susceptibility test was done on Muller-Hinton agar using antibiotic discs. At the time of delivery, infant’s birth weight and gestational age was recorded on the log book as part of the daily work. Fetal outcome data were recorded from the log book and entered to EPI data management software then transferred to SPSS for analysis. Results:Out of 424 urine samples processed, 63 (14.9%) yielded significant bacteriuria. Fifty-nine out of 63 (93.7%) cases of UTIs were recorded among age group of 15-34 years. Escherichia coli, Klebsiellapneumoniae, and Staphylococcus aureus were the three dominant bacterial isolates. Most of the gram negative bacterial isolates were resistant to ampicillin and ceftazidime (43.2% each) while gram positive was resistant for tetracycline (36.8%). The result of this study showed that UTI had statistical association with the occurrence of Intrauterine Fetal Death (IUFD) and Prerupture of Membrane (PROM) (P<.05). Conclusion: Adverse fetal outcomes are significantly linked with the presence of UTI during pregnancy. The condition can be managed if early diagnosis and treatments are made for the mother
Highlights
Urinary tract infection (UTI) is a commonly encountered health problem among pregnant women
The result of this study showed that UTI had statistical association with the occurrence of Intrauterine Fetal Death (IUFD) and Prerupture of Membrane (PROM) (P
Adverse fetal outcomes are significantly linked with the presence of UTI during pregnancy
Summary
Urinary tract infection (UTI) is a commonly encountered health problem among pregnant women. The urinary tract includes the organs that collect and store urine and release it from the body and these organs include the kidneys, ureters and bladder, urethra and accessory structures [1]. A urinary tract infection (UTI) is an infection caused by growth of microbes to different structures involved in formation and elimination of urine namely the kidney, ureters, urinary bladder and urethra [2]. Based on the structures involved, UTIs are medically classified as cystitis (if the infection is in the bladder), pyelonephritis (if kidney is affected by the infection), ureteritis (ureter infection) and urethritis (infection in the urethra) [2]. During the course of pregnancy, the enlarging uterus creates a pressure on nearby ureters and bladder which results a delay in urine flow and prevent complete emptying of urine; this condition places an opportunity for growth of microbes within the urinary tract [7]. ; an increased bladder volume along with decreased bladder and urethral tone enhances bacterial growth in pregnant women [6, 8, 9]
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