Prevalence Of Asymptomatic Bacteriuria Research Articles

PREVALENCE OF ASYMPTOMATIC BACTERIURIA AMONG WOMEN WITH DIABETES MELLITUS - A PROSPECTIVE CROSS-SECTIONAL STUDY

Background: There are many studies demonstrating the risk factors of asymptomatic bacteriuria (ASBU) in diabetic women. ASBU is a well-established risk factor for frequent urinary tract infections (UTIs) in women, and the risk factors that predispose diabetic women to ASBU has to be further evaluated. Aim: To estimate the prevalence of asymptomatic bacteriuria among women with diabetes mellitus .To verify if there is a correlation between bacteriuria and the duration of diabetes and also the correlation between bacteriuria with the metabolic control of diabetes. Materials And Methods: Patients who were admitted in Sree Mookambika Institute of Medical Sciences, Kulasekharam from February 2019 to November, 2020 were included in our study. Two hundred women with diabetes mellitus were enrolled in the study. A control group of 75 healthy women were randomly selected without diabetes was also evaluated in the same period.All relevant clinical information, data was collected. Patients were categorised into variables and mean, SD, Levene’s test of homogeneity of variance, linear regression was calculated. Results: 200 diabetic women were included in our study and 75 healthy women were selected as control. 150 patients were included in the study out of which 95 were males and 55 were females 40% had unstable Angina, 7% had NSTEMI and 53% had STEMI. prevalence of anaemia was 50% of the study population. Anaemia varied according to gender and was more in women 70.9% when compared to men 27.3%. Anaemia was also found to be higher in higher age groups and was more in patients with associated co morbidities such as chronic kidney disease,hypothyroidism and diabetes . Anaemia patients were also found to have more incidence of unstable angina when compared to other forms of ACS. The most common anaemia found was Microcytic hypochromic iron deficiency anaemia 32%. Out of those with iron deficiency, upper GI bleed was the most common cause in our patients. Triple Vessel Disease (TVD) patients were also found to have more incidence of anaemia than those with DVD and SVD. Conclusion: Urinary tract infection is one of the major disease burden for many patients having diabetes mellitus. Asymptomatic bacteriuria (ASB) is several-fold more common among diabetic women than healthy women. The risk of asymptomatic bacteriuria increases with increasing age. The duration of diabetes mellitus has significant correlation with development of asymptomatic bacteriuria among diabetic women. A significant impairment of metabolic control of diabetes shows an overall increase in the risk of developing asymptomatic bacteriuria. Keywords: Asymptomatic Bacteriuria, Diabetic Women, UTI

Asymptomatic Urinary Tract Infection among Female University Students

Background: Asymptomatic urinary tract infections (AUTI) are common in apparently healthy populations and are detectable in the laboratory as 'significant bacteriuria’. Aim of the study: This study aimed to assess the asymptomatic bacteriuria among the university students and to examine the student's practices and risk factors that contribute to the occurrence of asymptomatic bacteriuria. Subject and Method: A descriptive cross-sectional study included 184 student selected by stratified random sampling technique. Data were collected using self-administered online questionnaires that included a personal data, history of UTI, health-related hygienic practices and dietary preference has and habits. Urine investigation was done for the participated students. Descriptive statistics, cross-tabulation were used for data analysis. Results: The finding showed that nearly one-third of the study participants reported had a previous history of urinary tract infection. The most repeated complaint was urgency (31%) and side pain (26.6%). Results revealed that (40.2%) were positive for significant bacteriuria. There was a negative association in the prevalence of asymptomatic bacteriuria with respect to age. (40.2%). Escherichia Coli was the most predominant organism followed closely by Staphylococcus aureus. Ciprofloxacin to be the most effective antibiotic followed by Amikacin and Nitrofurantoin. Ampicillin, Cloxacillin, and Erythromycin were highly resistant to the isolates. Conclusion: The results of this study emphasize the importance of raising students’ awareness and habitual practices as a primary prevention of the urinary tract infection. Recommendation: Routine urine culture test should be carried out periodically to early detect asymptomatic bacteriuria

Prevalence of Asymptomatic Bacteriuria, Associated Factors and Antimicrobial Susceptibility Profile of Bacteria Among Pregnant Women Attending Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

IntroductionAsymptomatic bacteriuria (ASB) is the presence of bacteria in significant quantity in the absence of signs and symptoms of urinary tract infection (UTI). ASB, if it occurs during pregnancy, can cause serious complications both among fetus and pregnant women.ObjectiveThe aim of this study was to determine the prevalence of ASB, its associated factors, and antimicrobial susceptibility profile of bacterial isolates among pregnant women.MethodsA cross-sectional study was conducted from July to September 2019 among 290 pregnant women at Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Clean-catch midstream urine specimens were collected using sterile containers and cultured on MacConkey agar and sheep blood agar to isolate bacteria. Socio-demographic and obstetric data were collected using a structured questionnaire. Data were analyzed by SPSS version 22. The association between ASB and risk factors was assessed using logistic regressions. A p-value ≤0.05 was considered as a cut point to determine the significant association.ResultsFrom 290 study participants, 16.9% with 95 CI [13.1, 21.5] were positive for ASB. The predominant bacteria were Escherichia coli (43%) and Staphylococcus aureus (20%). Majority of E. coli (91.0%) were susceptible to nitrofurantoin and gentamycin; most of them were resistant to amoxicillin (86.4%) and cotrimoxazole (77.7%). The proportion of multi-drug resistance (MDR) isolates was 57.1%. Previous infection with UTI, previous history of catheterization, and natural abortion were significantly associated with ASB.ConclusionIn the study area, ASB is prevalent in the study area indicating the importance of screening of ASB and possible treatment to prevent its consequences.

The risk of urine bacterial colonisation in patients with a permanent catheter after caesarean section

We present an observational study, conducted in Slovakia, concerning the occurrence of newly acquired urine colonisations in women with Foley catheters after a Caesarean section. A sample of urine was taken from each patient when the Foley catheter was first inserted, before the operation and was sent to the lab for culture. Later, a sample of urine was taken during the removal of the Foley catheter. Out of 176 women, the second urine sample culture result was positive in 13 women. Of those nine women had a positive pathogenic strain (5.1%). The prevalence of asymptomatic bacteriuria in our cohort was 7.7%. De novo acquired colonisation of urine was confirmed in 5.1% of cases. The only confirmed risk factor was delivery by an acute Caesarean section. Impact statement What is already known on this subject?: It is well known that catheterisation increases risk of colonisation of lower urinary tract by pathogens. However, the extent of this risk is not determined because there are no studies of de novo colonisation in women with sterile urine before catheterisation. According to literature approximately 8% of women have asymptomatic bacteriuria, which could be confounding factor in previous studies. What do the results of this study add?: Our study excluded women with positive bacteriuria before insertion of Foley catheter. Therefore, the study only assesses de novo colonisation, dependent on insertion of Foley catheter during caesarean section. What are the implications of these findings for clinical practice and/or further research?: De novo colonisation was observed in 5.1% of women in our cohort, with emergency caesarean section as a confirmed risk factor. Therefore, practitioners should consider avoiding catheterisation during caesarean section.

Asymptomatic Bacteriuria among Pregnant Women Attending Antenatal Care at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia: Magnitude, Associated Factors, and Antimicrobial Susceptibility Pattern.

Background Asymptomatic bacteriuria is one of the major risk factors for the development of urinary tract infections during pregnancy which accounts for about 70% of the cases. However, there is no guideline which recommends routine screening of pregnant women for asymptomatic bacteriuria in most of developing countries including Ethiopia. Thus, the aim of this study was to determine the magnitude, associated factors, and antimicrobial susceptibility pattern of asymptomatic bacteriuria among pregnant women. Methods A cross-sectional study was conducted from March to April 2019. Data were collected through face-to-face interview and analyzed using Statistical Package for Social Science version 22. A test of association was performed using logistic regression and P value less than 0.05 was considered statistically significant. Results The overall prevalence of asymptomatic bacteriuria was 19.9%. Direction of wiping after genital wash, postcoital urination, and catheterization were factors significantly associated with asymptomatic bacteriuria. Most of the isolated Gram positive were highly sensitive to Ceftriaxone (90.9%). Coagulase-negative staphylococci showed higher sensitivity to Augmentin (75.0) and Ceftriaxone (87.5%), whereas they showed resistance to Clindamycin (68.7%) and Ampicillin (62.5%). Gram-negative bacteria isolates showed higher sensitivity to Ceftriaxone (88.2%), Gentamycin (67.5%), and Augmentin (64.7%), while they showed resistance to Ampicillin (70.5%) and Clindamycin (50.0%). Conclusion The overall prevalence of asymptomatic bacteriuria among pregnant women in this study was high. Direction of wiping after genital wash, catheterization, and postcoital urination increases the odds of asymptomatic bacteriuria. Therefore, health education on the predisposing factors is strongly recommended.

Asymptomatic bacteriuria prevalence

Asymptomatic bacteriuria prevalence

Assessment of asymptomatic bacteriuria and sterile pyuria among antenatal attendants in hospitals in northern Ghana

BackgroundAsymptomatic bacteriuria (ASB) and sterile pyuria (SP) are complexities of UTI whose prevalence are not known in the northern sector of Ghana. Our aim was to determine the occurrence of sterile pyuria and asymptomatic bacteriuria among pregnant women accessing antenatal care at a secondary and tertiary care hospitals in Tamale, northern Ghana.MethodsA cross sectional study was conducted by screening 530 pregnant women with no signs of acute urinary tract infection attending antenatal clinic for a period of 6 months. Midstream urine was collected for microscopy, quantitative urine culture and antibiotic susceptibility testing. Data analysis was carried out using the Statistical Package for Social Sciences version 20.ResultsAsymptomatic bacteriuria was respectively 20 and 35.5% at Tamale Central and Tamale Teaching Hospital out of the 390 and 90 women screened. Sterile pyuria was found among 66% of the 50 women presenting at Tamale Central Hospital. More than 64% of isolates recovered from ASB patients were S. aureus and coagulase negative Staph. (CoNS). Escherichia coli was the dominant species among members of the enterobacteriaceae isolated. Highest susceptibility was recorded against gentamicin and amikacin while most resistance was to Ampicillin, cotrimoxazole, chloramphenicol and nitrofurantoin. Resistance to imipenem and vancomycin were 28.8 and 52%, with strains showing multiple drug resistance of between 81 and 92%.ConclusionThe prevalence of asymptomatic bacteriuria is appreciably higher (20–35.5%) than documented rates in the southern sector of the country. The presence of sterile pyuria which may be an indication of asymptomatic renal impairment and most often overlooked in antenatal management is 66%. Empirical treatment of UTIs at the Tamale Central and Teaching Hospital without confirmation of susceptibility may result in treatment failure. It is necessary to screen and treat pregnant women for ASB and SP due to the complications associated with these conditions.

Prevalence of Asymptomatic Bacteriuria and Antibiotic Susceptibility Patterns of Bacterial Isolates among Cancer Patients and Healthy Blood Donors at the University of Gondar Specialized Hospital.

Background Urinary tract infections are the common types of infections in the community and health care settings. Despite the widespread availability of antibiotics, urinary tract infection remains a worldwide therapeutic problem. It is a continuous and significant problem in cancer patients. Methods A hospital-based comparative cross-sectional study was conducted on 240 study participants from January to June 2019. Sociodemographic data were collected by a predesigned questionnaire and midstream urine samples collected using simple random sampling technique by using clean, sterile plastic cups and then inoculated onto CLED agar plates and incubated at 37°C for 24 hours. Urine culture was considered significant bacteriuria when colony forming units ≥105/mL of voided urine and a single pure colony suspended in nutrient broth and then subcultured onto a blood agar plate and MacConkey agar plate, incubated at 37°C for 24 hours for identification. Identification was done by using standard microbiological methods. Modified Kirby–Bauer disk diffusion technique was applied for antimicrobial susceptibility testing in accordance with CLSI 2018 criteria. Data were entered, cleared, and checked using Epi Info version 7 and exported to SPSS version 20 for analysis. The results were displayed using tables and figures. p value <0.05 at 95% CI was considered as statistically significant. Results The overall prevalence of asymptomatic bacteriuria in cancer patients was 23.3% while 6.7% in apparently healthy blood donors. E. coli (32.1%) was the commonest isolated uropathogenic bacteria followed by Klebsiella species (25.0%), S. aureus (21.4%), Enterococcus species (10.7%), Serratia species (7.1%), and Enterobacter aerogenes (3.6%) in cancer patients. In apparently healthy blood donors, E. coli, Klebsiella species, and S. aureus were isolated from 75%, 12.5%, and 12.5%, respectively. Most Gram-negative bacteria were more sensitive to ceftazidime, cefoxitin, nalidixic acid, nitrofurantoin, norfloxacin, ciprofloxacin, and tobramycin, whereas highly resistant to ampicillin, penicillin, tetracycline, and ceftazidime. S. aureus isolates were 100% susceptible to nitrofurantoin. Conclusions This study showed a high prevalence of asymptomatic bacteriuria among cancer patients (23.3%) compared to apparently healthy blood donors (6.7%). E. coli was isolated predominately. Nitrofurantoin and ciprofloxacin should be used to treat asymptomatic bacteriuria in the study area.

Occurrence of Multidrug-resistant Uropathogens Implicated in Asymptomatic Bacteriuria in Adults with Sickle Cell Disease in Ile-Ife, Southwest Nigeria.

ObjectivesWe sought to determine the prevalence of asymptomatic bacteriuria (ASB) in patients with sickle cell disease (SCD), the susceptibility profile of its agents and their extended-spectrum β-lactamase (ESBL) production.MethodsFifty-nine patients with SCD and 116 healthy controls were investigated. Urine samples were collected and cultured by standard techniques. We used the disc diffusion technique to determine antibiotic susceptibility. ESBL was detected by the combination disc method and detection of blaSHV, blaTEM, and blaCTX-M genes by multiplex-polymerase chain reaction.ResultsThe prevalence of ASB was higher among patients with SCD (8.6%) than controls (0.9%) (p = 0.016), predominantly among females. Coagulase-negative staphylococci (n = 2; 33.3%) predominated among the isolates. Other uropathogens included Stenotrophomonas maltophilia, Acinetobacter baumannii, and Enterobacter cloacae. All isolates were sensitive to meropenem but were resistant to ceftazidime, ampicillin, and tetracycline. blaSHV, blaTEM, and blaCTX-M-15 were detected in Enterobacter cloacae.ConclusionsThe prevalence of ASB is high in patients with SCD predominantly among females. Rare multidrug-resistant uropathogens were implicated. We posit a need for resistance surveillance programs and antibiotic stewardship to prevent treatment failure and reduce drug resistance.

5 Improving Diagnosis and Management of Urinary Tract Infections for Elderly Patients

Abstract Introduction Diagnosis of urinary tract infection (UTI) in the elderly population is challenging as they commonly present with atypical signs and symptoms. Prevalence of asymptomatic bacteriuria in the elderly population is high. Hence, urine dipstick and urine culture are no longer diagnostic tests. UTI is over-diagnosed and overtreated in the elderly, resulting in poor antimicrobial stewardship. This project was carried out to assess and improve the current practices in the diagnosis and treatment of UTI in the Department of Medicine of the Elderly. Methods We reviewed current Scottish Intercollegiate Guidelines Network (SIGN) and National Institute for health and Care Excellence (NICE) guidelines on management of UTI and defined indications for performing urine dipstick and sending urine culture. We then collected and assessed data on all urine dipsticks performed, urine cultures sent, and use of antibiotics in treating UTI and asymptomatic bacteriuria in three Medicine of the Elderly wards in Aberdeen Royal Infirmary. We carried out intervention by means of presenting and discussing findings of Plan-Do-Study-Act (PDSA) cycles in departmental multi-disciplinary Quality Improvement (QI) meetings followed by educational sessions. Results Our baseline data showed 77% of urine dipsticks were performed without clinical indication and 18% of patients had urine cultures sent without clinical indication. After presenting our initial findings and carrying out an educational intervention session, 25% of patients had urine dipstick done without clinical indication, and 0% of patients had urine cultures sent without clinical indication. However, over the course of four subsequent PDSA cycles, practices in investigation of UTI fluctuated but were overall consistently better than the initial practice with further interventions. In all PDSA cycles, no patients were treated for asymptomatic bacteriuria. Conclusions Multidisciplinary team involvement in discussion of this QI project findings and educational sessions proved to be an effective form of intervention for improving current practice.

The management of urinary tract infections in a district general hospital – a closed loop service review and comparison with SIGN guidelines

Elderly patients with new onset of confusion or being ‘off legs’ is a common presenting complaint on the acute take. Urinary tract infections (UTI) are common in the elderly population, often a diagnosis is made based on a positive urine dipstick in the absence of urinary symptoms. However, these patients may actually have asymptomatic bacteriuria (AB). The prevalence of AB in institutionalised women above the age of 65 have been reported to be as high as 57%.1 Bacteriuria is not a disease, and treating it is not advised under the Scottish Intercollegiate Guidelines Network (SIGN) guidelines.2 We looked …

Asymptomatic bacteriuria among 12 to 16 weeks of gestation and their perinatal outcome

Urinary tract infections (UTIs) is an infection caused by the presence and growth of microorganism anywhere in urinary tract. The prevalence of asymptomatic bacteriuria during pregnancy is 2% to 14% in India. Adverse maternal outcomes include symptomatic cystitis and development of pyelonephritis (in up to 30%) and preterm labor and delivery. Asymptomatic bacteriuria (ASB) is an entity with possibly serious consequences in the form of fetal and maternal morbidity. 200 randomly selected pregnant women, attending outpatient or inpatient department of D Y Patil Hospital kadamwadi, were included in study. Prevalence of asymptomatic bacteriuria in the study population was 19.5%. Common pathogen was E.coli occuring in 48.7%. The most sensitive antibiotic was nitrofurantoin. Maternal morbidity was higher in those with asymptomatic bacteriuria 76.9%.Those without asymptomatic bacteriuria had lesser morbidity 31.7%. Maternal morbidity spontaneous were miscarriage 7.7%, preterm labour 13.9%, premature rupture of membrane 13.9%. Fetal morbidity was higher in those whose mothers had asymptomatic bacteriuria. Fetal morbidity were prematurity 11.1%, low birth weight 8.3% were significantly increased. If unrecognized and un-treated, ASB leads to adverse perinatal outcome. We conclude that, all pregnant women are to be screened for ASB, preferably in the pre-conceptional period or at-least in the 1st trimester

Prevalence of asymptomatic Bacteriuria among Pregnant Women Attending Antenatal Clinic at Plateau State Specialist Hospital, Jos, Nigeria

Asymptomatic bacteriuria (ASB), common occurrence in pregnancy usually results in maternal and fetal complications. Bacterial infection is often missed in pregnancy because urine microscopy, culture and sensitivity is not part of the approved laboratory tests for women attending antenatal clinic (ANC)s in Nigeria. This study was a cross-sectional, laboratory-based study involving 136 first-, second-, and third trimester, consecutive pregnant women attending ANC at the Plateau State Specialist Hospital Jos, who gave informed consent and submitted urine samples for the determination of prevalence of ASB using Cysteine Lactose Electrolyte Deficient (CLED) agar by the standard loop technique and microscopy. Demographic data was obtained by administering structured questionnaire to the study participants. Data obtained were analyzed using SPSS version 21and p values <0.05 were considered statistically significant. Out of 136 urine samples examined 10.3% were positive for ASB. Of the total ASB isolates, 71.4% was Escherichia coli, the most prevalent uropathogen, followed by Staphylococcus aureus (14.3%) while others were 14.2%. Age group 24-28 years had the highest prevalence 5.1% followed by 19-23 years age group with 2.2%. The lowest prevalence was age groups 29-33 and 34-50 years with prevalence of 1.5% each. In respect to trimesters, second and third trimester recorded the highest with 4.4% each while the first trimester had 1.5%. Based on the antibiogram, Ciprofloxacin and Sparfloxacin were found to be most effective antibiotics against Escherichia coli and Staphylococcus aureus. This study revealed high prevalence of ASB among antenatal women in the population studied. Further study with larger sample size covering the entire state is advocated to discover the possibility of making bacterial microscopy, culture and sensitivity part of antenatal care for the purpose of early diagnosis and proper management of pregnant women in plateau state.

Detection of ESBLs and NDM-1 genes among urinary Escherichia coli and Klebsiella pneumoniae from healthy students in Niger Delta University, Amassoma, Bayelsa State, Nigeria

INTRODUCTION: Increasing emergence of multidrug-resistant uropathogens among healthy individuals is a serious public health problem capable of causing difficult-to-treat urinary tract infections (UTIs) with limited treatment options. This study therefore, determined the prevalence of asymptomatic bacteriuria (ASB) and molecular characteristics of antibiotic-resistant Escherichia coli and Klebsiella pneumoniae isolated from healthy students of Niger Delta University, Amassoma, Nigeria. METHODS: mid-stream urine samples were collected from 303 healthy students and cultured for significant bacteriuria. Escherichia coli and K. pneumoniae were isolated and identified by conventional methods and Polymerase Chain Reaction (PCR). Antimicrobial susceptibility patterns of the isolates were determined by the disc diffusion technique. The isolates were screened for Extended-Spectrum Beta-Lactamases (ESBLs) production by combined disc method, ESBLs and carbapenemases genes by PCR. RESULTS: the prevalence of ASB was 21.1%, with a significantly higher proportion among the females (P < 0.0001). Escherichia coli and K. pneumoniae isolates were recovered in equal proportion (n=21; 6.9%), with E. coli significantly isolated from the females (P= 0.002). The isolates exhibited 57 - 95% resistance to cefotaxime, ceftazidime, and co-trimoxazole, and 10 - 24% resistance to levofloxacin and imipenem. Multidrug resistance (MDR) was found in 9 (42.9%) E. coli and 18 (85.7%) K. pneumoniae isolates; 60% of E. coli and 72.7% of K. pneumoniae were ESBLs producers. blaTEM (50%) and blaCTX-M (30%) were detected in E. coli while blaSHV (83.3%) and blaTEM (55.6%) were detected in K. pneumoniae. One E. coli and two K. pneumoniae isolates harboured NDM-1 gene. CONCLUSION: the ASB from this study’s healthy individuals was characterized by MDR bacteria that harboured ESBLs and NDM-1 genes. Thus, emphasizing the need for regular surveillance of bacterial resistance and proper hand hygiene to contain the spread of MDR pathogens in the community.

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

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.

Asymptomatic bacteriuria in pregnancy

Aims: To estimate the prevalence of asymptomatic bacteriuria, its causative agents and their antimicrobial susceptibility pattern; and to determine the relationship of asymptomatic bacteriuria and pyuria in pregnant women.&#x0D; Methods: A cross sectional study was conducted in a total of 240 asymptomatic pregnant women in Paropakar Maternity and Women’s Hospital from August 2016 to January 2017. Clean catch midstream urine samples were collected from each participant. Urine samples were cultured using standard microbiological methods. Identification of isolates and antibiotic sensitivity testing were done.&#x0D; Results: Out of 240 pregnant women, 17 (7.1%) were positive for asymptomatic bacteriuria [colony forming unit (CFU) &gt;10 5 /ml]. There was no any significant difference in the prevalence of asymptomatic bacteriuria with respect to age, gestational age and parity. The prevalence of asymptomatic bacteriuria was significantly different with respect to education level (p=0.01) and number of pus cells in urine specimen (p=0.04). The most frequently isolated microorganisms were E.coli (70.6 %) followed by Klebsiella spp (11.8%). Ciprofloxacin followed by Nitrofurantoin and Norfloxacin had the highest sensitivity to all the isolates.&#x0D; Conclusions: Asymptomatic bacteriuria is common in pregnancy. Routine urine culture should be done on all pregnant women to detect asymptomatic bacteriuria. Treatment should be based on antimicrobial sensitivity pattern due to increased antibiotic resistance to commonly used antimicrobial agents.

Prevalence of Asymptomatic Bacteriuria in Children: A Meta-Analysis

To determine the point prevalence of bacteriuria and bacteriuria without pyuria in asymptomatic children by a systematic review of the literature. We searched MEDLINE and EMBASE for English-, French-, German-, Italian-, and Spanish-language articles. We included articles reporting data on bacteriuria in asymptomatic children up to 19years of age who had urine collected by suprapubic bladder aspiration, bladder catheterization, or by 3 consecutive clean catch samples. Two independent reviewers assessed studies for inclusion and abstracted data. Fourteen studies (49 806 children) were included. The prevalence of asymptomatic bacteriuria was 0.37% (95% CI, 0.09-0.82) in boys and 0.47% (95% CI, 0.36-0.59) in girls. The corresponding values for asymptomatic bacteriuria without pyuria were 0.18% (95% CI, 0.02-0.51) and 0.38% (95% CI, 0.22-0.58), respectively. The subgroups with the highest prevalence of asymptomatic bacteriuria were uncircumcised males <1year of age andfemales>2years of age. In males, the prevalence of asymptomatic bacteriuria after infancy was 0.08% (95% CI, 0.01-0.37). The median duration of asymptomatic bacteriuria in untreated boys and girls, from the one study reporting this outcome, was 1.5 and 2months, respectively. Some clinicians are concerned that when a preverbal child with asymptomatic bacteriuria develops a nonlocalizing febrile illness and presents for evaluation, they may be mistakenly diagnosed as having a urinary tract infection (UTI). Given that the prevalence of asymptomatic bacteriuria is considerably lower than the prevalence of UTI in most subgroups examined, this will occur extremely rarely. These data suggest that the current definition of UTI should be revisited.

ANTIBIOTIC EXPOSURE IN LONG-TERM CARE FACILITIES IS ASSOCIATED WITH URINARY MICROBIOME PERTURBATIONS

The discovery of the human urinary microbiome, defined as the microbial communities which colonize the human urinary tract, has shed new light on the meaning and clinical significance of bacteriuria. The prevalence of asymptomatic bacteriuria has been reported to be as high as 50% in healthy older adults living in long term care facilities, yet the urinary microbiome of this population has not been reported. The aim of this pilot study was to describe the urinary microbiome of this population and explore the cross-sectional relationship with recent antibiotic exposure. Voided urine samples were obtained from healthy, institutionalized older adults (ages 79 to 95), including non-catheterized men and women without any urinary symptoms. The bacterial genomic content of each urine sample was assessed by 16S rRNA sequencing. Among the 77 genera found across 16 urine samples, there was no significant difference in the microbial diversity across age groups. When grouped by antibiotic exposure, those recently exposed had a significantly lower diversity (Shannon’s index of 2.16 vs. 2.61, p = 0.029), and lower evenness (Pielou’s evenness of 0.58 vs. 0.69, p= 0.017) relative to those who were not recently exposed. Enrichment analysis showed that recent antibiotic exposure was associated with an increased abundance of the genus Bacteroides and decreased abundance of the genus Streptococcus. To our knowledge, this is the first report describing the urinary microbiome of institutionalized older adults and suggests that recent antibiotic exposure should be accounted for in future studies of the urinary microbiome in this population.

UTI Management: It’s All in the Culture

UTI Management: It’s All in the Culture

Prevalence of Asymptomatic Bacteriuria among Pregnant Women Attending Antenatal Care at the Korle-Bu Teaching Hospital Accra, Ghana: A Cross-sectional Study

Background: The significance of asymptomatic bacteriuria (ASB) relates to its potential to cause acute pyelonephritis, preterm labour and preterm rupture of the membranes. Additionally, it has been associated with clinical conditions such as anaemia, preterm birth, low birth weight and perinatal mortality.&#x0D; Aim: This study, therefore, determined the prevalence of ASB among pregnant women attending the antenatal clinic. &#x0D; Materials and Methods: A cross-sectional study using convenient sampling method was used to recruit 200 pregnant women attending antenatal care at the Korle-Bu Teaching Hospital (KBTH) from January – April 2014. Bacteriological, urine chemistry and routine urine analyses, as well as antibiotic susceptibility profile of bacterial isolates from mid-stream urine samples of pregnant women, were carried out using appropriate standard methods. Variables were reported in mean, standard deviation, percentages and bar graph. Chi-square test was used to establish statistical difference and association between variables where p-value &lt;0.05 was considered statistically significant.&#x0D; Results: Out of the total participants, 23 had asymptomatic bacteriuria but no prevalence of ASB was found among Muslims. The association between marital status and the prevalence of ASB was significant (Pearson chi2 = 4.88, p-value = 0.027). Five bacterial isolates were obtained with Escherichia coli (43.6%) being the most prevalent organism. There were more negative reactions than positive reactions with regards to nitrite and leukocyte esterase determination. Both gram-positive and negative isolates recorded high susceptibility to Gentamicin and Norfloxacin. However, Ciprofloxacin showed a high rate of resistance to only gram-negative isolates whiles Chloramphenicol, Ampicillin and Amoxicillin showed high resistance to gram-positive isolates.&#x0D; Conclusions: The overall prevalence of asymptomatic bacteriuria was 11.5% [95%CI: 7.4% - 16.8%] among the referral pregnant women attending KBTH with Escherichia coli being the most prevalent organism whiles the most susceptible antibiotics were Gentamicin and Norfloxacin.