Prevalence Of Asymptomatic Bacteriuria Research Articles

Don’t omit a urine culture when a urinalysis is suspicious for asymptomatic bacteriuria during pregnancy

Abstract Introduction/Objective Investigation of a clinical problem using steps of evidence-based practice (EBP) led to the development of a recommendation submitted for Choosing Wisely consideration. The prevalence of asymptomatic bacteriuria (ASB) in pregnancy is between 2-15%. ASB may be a concern in pregnancy because of its capacity for association with adverse outcomes, namely preterm delivery, low birthweight, and possible progression to pyelonephritis. Screening and treatment may reduce the risks of adverse outcomes, but data is not current. A point-of-care urine dipstick is low cost and commonly used at routine obstetrician clinic visits to screen for ASB. The urinalysis dipstick is associated with high false-positive and false-negative rates as compared to the gold standard urine culture. Some providers make the decision to treat ASB given a positive urinalysis screen without ordering a follow-up culture. Such practice could lead to overtreatment of the patient and poor antibiotic stewardship. Research question Is a urinalysis without culture sufficient for diagnosis and treatment of ASB during pregnancy? Methods/Case Report Laboratory Medicine Best Practices A-6 steps of Ask, Acquire, Appraise, Apply, Analyze, and Assess were utilized to develop an appropriate and relevant clinical question, collect literature, determine evidence value, assign ratings, implement into practice, and evaluate outcomes. During appraisal, six selected articles were graded according to study rating, practice, measures, and results, further including the final rating and effect size rating. Consistency and overall strength of the evidence were analyzed. Results (if a Case Study enter NA) Each evidence study demonstrated final ratings between 8 and 10, a rating of “Good,” and an effect size rating of “Substantial.” Consistency leads to a “High” overall strength among the body of evidence. Conclusion Obtain a urine culture if routine prenatal point-of-care dipstick urinalyses have findings consistent with asymptomatic bacteriuria. Urinalyses are limited as screening due to low sensitivity and specificity for bacteriuria. Positive urinalysis dipstick results should be neither the sole basis for diagnosis nor decision to treat.

PREVALENCE OF ASYMPTOMATIC BACTERIURIA AND ITS MICROBIOLOGICAL PROFILE IN PREGNANCY AT TERTIARY CARE HOSPITAL, JABALPUR

Objective: To determine the prevalence of asymptomatic bacteriuria (ASB), microbiological profile, and pregnancy outcome in asymptomatic pregnant women. Methods: Pregnant women attending outpatient clinic were selected randomly. Urine sample by clean catch method collected and battery of tests were performed. Prevalence of ASB and pregnancy outcome studied. Results: Total 114 pregnant women were studied, out of which 6 cases were positive for urine culture. Prevalence rate in our study found to be 5.3%. Study depicted that 33.4% women with asymptomatic bacteriuria had premature rupture of membranes, 16.7 % women had pre-eclampsia and 16.7% had severe anemia. 50 % babies were premature, 33.4% had fetal growth restriction and 16.7% developed acute respiratory distress syndrome. Conclusion: Urinary tract infections are common during pregnancy. Asymptomatic bacteriuria can progress to pyelonephritis and may result in adverse pregnancy outcome. Prevalence rate found to be 5.3%. Premature rupture of membranes and premature births were major adverse pregnancy outcome. E. coli was most common bacterial isolate found in the study and was highly sensitive to cefuroxime sodium. Pregnancy complications may be avoided by using regular screening with urine cultures.

Prevalence of Asymptomatic Bacteriuria among Patients Attending Diabetic Clinic at Fort Port Regional Referral Hospital, Uganda Patients

The availability of high concentration of sugar in the blood of diabetic patients makes them more susceptible to developing bacterial infections which are asymptomatic commonly referred to as asymptomatic bacteriuria (ASB) than the non-diabetic patients. Diabetes patients with ASB have a much higher risk of developing diabetic complications than individuals without ASB. There is a paucity of data on the burden of ASB and antimicrobial susceptibility in diabetes patients in Uganda. Between March and May 2023, a cross-sectional study was carried out at the Fort Portal Regional Referral Hospital, Uganda outpatient diabetic clinic and 160 diabetes patients were recruited for the study. Mid-stream urine was taken for culture and sensitivity. Data analysis were performed using IBM SPSS version 20. A pie chart was used to display the prevalence and antimicrobial susceptibility patterns of common uropathogens described in frequency and percentages. The overall prevalence of ASB among the study participants was 11%. The most common uropathogen isolated was Escherichia coli, followed by Klebsiella and S. aureus. The most sensitive drug in all the isolates was Nitrofrantoin and resistant drug was Ampicillin. In conclusion, routine testing for ASB and treatment should be according to the antimicrobial susceptibility of diabetic patients.

Risk Factors and Clinical Outcomes of Asymptomatic Bacteriuria in Pregnant Women: A Comprehensive Analysis.

Background Asymptomatic bacteriuria (ASB) in pregnant women poses risks to maternal and neonatal health. Understanding its prevalence and associated risk factors is crucial for effective management. This study aimed to determine the prevalence of ASB among pregnant women and identify associated risk factors. Methodology A cross-sectional study involving 294 pregnant women was conducted. ASB prevalence was determined, and bivariate analysis was performed to identify associated risk factors. Logistic regression analysis was employed to assess the significance of identified risk factors. Results The overall prevalence of ASB was 17.34%. Bivariate analysis revealedassociations between ASB and maternal age (p > 0.05), socioeconomic status (p < 0.001), previous urinary tract infection (UTI) history (p < 0.001), diabetes mellitus (p = 0.00204), and anemia (p = 0.522). Multivariate logistic regression confirmed significant associations of ASB with maternal age (p = 0.008), parity (p = 0.001), previous UTI (p < 0.001), and diabetes mellitus (p < 0.001). Conclusion This study underscores the importance of screening for ASB during prenatal care, particularly among pregnant women with advanced maternal age, higher parity, previous urinary tract infection (UTI) history, and diabetes mellitus. Tailored screening strategies and prompt treatment can mitigate the risks associated with untreated ASB, improving maternal and neonatal outcomes. Healthcare providers should integrate these findings into routine antenatal care protocols to optimize maternal and fetal health.

Online Search Strategies and Results From a Crowdsourced Survey on Asymptomatic Bacteriuria.

Despite the prevalence of asymptomatic bacteriuria (ASB), what proportion of the population is aware of this condition and the quality of internet resources are currently unknown. This study aimed to use an online crowdsourcing platform to explore general knowledge and internet search strategies, along with the quality of information, on ASB. An online survey was administered through a crowdsourcing platform to women 50 years or older via Qualtrics, which is a sophisticated online survey tool. Participants completed a survey on ASB, and participants were asked how they would search the internet for information both on urinary test results and on ASB. Outcomes included survey responses, and qualitative data were coded and analyzed thematically. χ2 Testing and regression modeling were used to look for variables associated with concern for ASB. There were a total of 518 participants who passed attention check qualifications, and only 45 respondents (8.7%) had heard of ASB. Many were concerned about progress to a worsening infection (n = 387 [77.6%]). When controlling for confounders, education beyond a college degree was not associated with a lower concern for ASB when compared with those with a high school education or less (adjusted odds ratio, 0.63; 95% confidence interval, 0.25-1.55; P = 0.31). Medical providers were the target audience for a majority of the websites, and many of the patient-facing results were of poor quality. Our national survey of women demonstrated a prevalent knowledge deficit surrounding ASB. We must seek to create high-quality, readily available, patient-facing information to increase awareness of ASB, allay concerns, and increase antibiotic stewardship.

Asymptomatic bacteriuria and its associated fetomaternal outcomes among pregnant women delivering at Bugando Medical Centre in Mwanza, Tanzania.

Asymptomatic bacteriuria (ASB) affects 23.9% of pregnant women globally and, if left untreated, can lead to adverse fetomaternal outcomes. In Tanzania, ASB prevalence has ranged from 13% to 17% over the past decade. Yet, its impact on fetomaternal outcomes remains unexplored, hindering the development of screening strategies, antimicrobial therapies, and preventive measures for this vulnerable population. A cross-sectional analytical study was conducted on 1,093 pregnant women admitted for delivery at Bugando Medical Center (BMC) in Mwanza, Tanzania, from July to December 2022. Socio-demographic, obstetric, and clinical data were collected from the women, along with mid-stream urine samples for analysis. Fetomaternal outcomes were assessed within 72 hours after delivery. The median age of participants was 29 years (range: 15-45 years). ASB prevalence among pregnant women was 16.9% (185/1093), with a 95% CI of 14.6-19.3%. Risk factors for ASB included anemia (OR: 5.3; 95% CI = 3.7-8.2, p-value <0.001) and a history of antenatal care admission (OR 4.2; 95% CI = 2.9-6.1, p-value <0.001). Among all participants, 82 (7.5%), 65 (5.9%), 49 (4.5%), and 79 (7.2%) experienced pre-term labor (PTL), premature rupture of membrane (PROM), preeclampsia, and delivered newborns with low birthweight (LBW), respectively. Among the 185 patients with ASB, the respective proportions of PTL, PROM, preeclampsia, and LBW were 25.4%, 17.3%, 9.2%, and 12.4%. Multivariable logistic regression analysis revealed significant associations between ASB and PTL [OR (95% CI): 8.8 (5.5-14.5); p-value <0.001], PROM [OR (95% CI): 4.5 (2.5-8.0); p-value <0.001], and LBW [OR (95% CI): 2.0 (1.2-3.5); p-value = 0.011]. Escherichia coli (50.8%) and Klebsiella pneumoniae (14.05%) were the most common pathogens, with low resistance rates to nitrofurantoin, amoxicillin-clavulanate, and cephalosporins-antibiotics considered safe during pregnancy-ranging from 8.2% to 31.0%. The prevalence of ASB among pregnant women in Tanzania remains high and is associated with adverse fetomaternal outcomes. Integrating routine urine culture screening for all pregnant women, irrespective of symptoms, and providing specific antimicrobial therapies during antenatal care can help prevent adverse pregnancy outcomes.

An insight into genes responsible for fosfomycin resistance among uropathogens of asymptomatic bacteriuria during pregnancy: A North Indian study.

Asymptomatic bacteriuria (ASB) is a common finding during pregnancy. Effective antibiotic treatment could reduce its adverse effects on both mother and fetus. However, emerging antimicrobial resistance limits the treatment options. Fosfomycin might be a promising drug in this regard, as its resistance is still low. The aim of the study was to determine the antimicrobial susceptibility pattern of fosfomycin in isolates causing ASB by disc diffusion and agar dilution (in selected isolates), determine minimum inhibitory contribution (MIC) by agar dilution in isolates resistant by disc diffusion and detect the genes responsible for fosfomycin resistance. This was a 2-year study carried in the Department of Microbiology, Jawaharlal Nehru Medical College and Hospital (JNMCH), Aligarh Muslim University (AMU), Aligarh. A total of 10 252 urine samples from asymptomatic pregnant females (18-45 years) attending the antenatal care (ANC) outpatient department (OPD) were submitted. Identification of pathogen and antimicrobial susceptibility testing (AST) was carried out as per standard methods of CLSI. There was phenotypic detection of methicillin-resistant Staphylococcus aureus (MRSA) and other Staphylococcus species (MRSS), high-level aminoglycoside resistance (HLAR), vancomycin resistant Enterococci (VRE) and S. aureus (VRSA), extended spectrum β-lactamase (ESBL) and carbapenem-resistant Enterobacterales (CRE). All the fosfomycin-resistant isolates (by disk diffusion) were tested by agar dilution. Conventional PCR was performed for murA, fosA, uhpT and glpT genes on all resistant isolates. In this study, the prevalence of ASB among pregnant females was 1173(11.4 %), in which Escherichia coli 495(42 %) was the predominant organism. The overall sensitivity of fosfomycin among Gram-positive cocci (GPC) and Gram-negative bacilli (GNB) was 99 % and 97.6 %, respectively. MRSA and MRSS accounted for 50 (66.6 %) and 71 (76 %), respectively. The highest rates of MIC >2048 µg ml-1 were shown by most isolates (mainly E. coli ) on agar dilution. PCR studies revealed four E. coli strains possessed both murA (also present in one K. pneumoniae strain) and glpT genes. While only one isolate ( E. faecalis ) was positive for fosA gene. But none of the strain possessed the uhpT gene. According to this study, murA and glpT genes were more frequent than fosA. We cannot comment on the prevalence and regional distribution of fosfomycin-resistant genes based on this preliminary study. Therefore, more Indian studies should be carried out to create awareness about the presence of genes in a particular area.

Asymptomatic bacteriuria in pregnant women attending antenatal clinic in a tertiary hospital, South-South Nigeria

Asymptomatic bacteriuria is a common problem in pregnancy and is associated with the risk of preterm birth and pyelonephritis if untreated. This study aims to determine the prevalence and aetiology of asymptomatic bacteriuria and the susceptibility pattern in pregnant women attending antenatal clinics in a tertiary hospital in South-South Nigeria. Urine samples from 30 pregnant women were analysed using conventional microbiology techniques, and the mean age of the respondents was 29.57±5.89 years. The prevalence of asymptomatic bacteriuria in this study is 66.6%, with a higher prevalence in the third trimester (73.3%). The subjects aged 31-35 had the highest prevalence of Klebsiella pneumoniae as the common isolate, followed by Escherichia coli at 45% to 40%, respectively. Reflacine was more susceptible to Escherichia coli (87.5%), while ciprofloxacin was more susceptible to Klebsiella pneumoniae (88.8%) in this study. Asymptomatic bacteriuria is not uncommon among antenatal patients in the population studied. Routine urine culture tests should be conducted on all antenatal patients to identify any unsuspecting infection. This measure will go a long way in reducing maternal and obstetric complications associated with pregnancy, such as preterm labour and low birth weight babies.

Asymptomatic Bacteriuria among Pregnant Women Attending Antenatal Care in Sudan

Background: Asymptomatic bacteriuria is common during pregnancy due to the apparent reduction in immunity of pregnant women, which appears to encourage the growth of both commensal and non-commensal microorganisms. The objective of this study was to determine the frequency of asymptomatic bacteriuria and identify the causative organisms among pregnant women. Methods and Results: This cross-sectional study was carried out at Ibrahim Malik Teaching Hospital and Bashaier University Hospital from April to July 2019 to assess the prevalence of asymptomatic bacteriuria among pregnant women. Fifty urine specimens were collected from pregnant women who didn’t show any signs or symptoms of UTI. Clean-catch mid-stream urine was collected into a sterile, universal container. Bacteriological culture and bacterial identification were carried out. The prevalence of asymptomatic bacteriuria in pregnant women in this study was 12%. Escherichia coli and Staphylococcus aureus were the most frequently isolated organisms: 2/6(33.3%) and 2/6(33.3%), respectively, followed by Proteus species 1/6(16.7%) and Klebsiella pneumonia 1/6(16.7%). Asymptomatic bacteriuria tended to increase from the first to the third trimester (1/8.3%, 2/11.1%, and 3/15%, respectively), but without statistical significance (P=0.845). We also found a trend to increase in the prevalence of asymptomatic bacteriuria with decreasing age: 2(15.4%) in the age group of 18-25 years, 3(11.5%) in the age group of 26-33 years, and only 1(9.1%) in the age group of 34-41 years (P=0.890). Conclusion: Periodic urine cultures should be performed routinely throughout pregnancy, especially during the first and third trimesters, to identify any unsuspecting unsuspected infection. Bacterial counts are of the most importance and should be done routinely. This measure will significantly reduce maternal and obstetric complications associated with pregnancy.

Incidence and risk factors of asymptomatic bacteriuria in patients with type 2 diabetes mellitus: a meta-analysis

BackgroundThe prevalence of type 2 diabetes mellitus (T2DM) is increasing each year and has become one of the most prominent health concerns worldwide. Patients with T2DM are prone to infectious diseases, and urinary tract infections are also widespread. Despite a comprehensive understanding of urinary tract infection (UTI), there is a lack of research regarding primary prevention strategies for asymptomatic bacteriuria (ASB).ObjectiveTo clarify the incidence and risk factors of asymptomatic urinary tract infection in patients with T2DM by meta-analysis to provide evidence for preventing UTI. Help patients, their families, and caregivers to identify the risk factors of patients in time and intervene to reduce the incidence of ASB in patients with T2DM. Fill in the gaps in existing research.Study designMeta-analyses were conducted in line with PRISMA guidelines.MethodsEleven databases were systematically searched for articles about ASB in T2DM, and the retrieval time was selected from the establishment of the database to February 5, 2023. Literature screening, quality evaluation, and meta-analysis were independently performed by two researchers according to the inclusion and exclusion criteria, and a meta-analysis was performed using Stata 17.0.ResultsFourteen articles were included, including cohort and case–control studies. A meta-analysis of 4044 patients with T2DM was included. The incidence of ASB in patients with T2DM was 23.7%(95% CI (0.183, 0.291); P < 0.001). After controlling for confounding variables, the following risk factors were associated with ASB in patients with T2DM: age (WMD = 3.18, 95% CI (1.91, 4.45), I2 = 75.5%, P < 0.001), female sex (OR = 1.07, 95% CI(1.02, 1.12), I2 = 79.3%, P = 0.002), duration of type 2 diabetes (WMD = 2.54, 95% CI (1.53, 5.43), I2 = 80.7%, P < 0.001), HbA1c (WMD = 0.63, 95% CI (0.43, 0.84), I2 = 62.6,%. P < 0.001), hypertension (OR = 1.59, 95% CI (1.24, 2.04), I2 = 0%, <0.001), hyperlipidemia (OR = 1.66, 95% CI (1.27, 2.18), I2 = 0%, P < 0.001), Neuropathy (OR = 1.81, 95% CI (1.38, 2.37), I2 = 0%, P < 0.001), proteinuria (OR = 3.00, 95% CI (1.82, 4.95), I2 = 62.7%, P < 0.001).ConclusionThe overall prevalence of ASB in T2DM is 23.7%. Age, female sex, course of T2DM, HbA1C, hypertension, hyperlipidemia, neuropathy, and proteinuria were identified as related risk factors for ASB in T2DM. These findings can provide a robust theoretical basis for preventing and managing ASB in T2DM.

P23 Prevalence of asymptomatic bacteriuria and associated risk factors in an adult population relevant to UK primary care: a systematic review and meta-analysis

Abstract Background The use of urine dipstick tests in people who are more likely to have asymptomatic bacteriuria (ASB) can lead to the over-diagnosis of urinary tract infection (UTI) and unnecessary antibiotic prescribing. As a result, urine dipsticks are not recommended in those over the age of 65 years, or those with a urinary catheter in UK primary care guidelines. However, due to variation in prevalence estimates for ASB and the age of some of the existing prevalence studies it is unclear whether the use of age 65 as a cut-off for dipstick testing remains appropriate. Objectives This systematic review aims to identify and synthesize more recent evidence around ASB prevalence and other risk factors relevant to a UK community context, in order to improve how UK primary care UTI diagnostic guidance addresses asymptomatic bacteriuria. Methods The protocol for this systematic review is registered with PROSPERO. Inclusion criteria are: study participants aged ≥18 years; prospective studies recruiting from a primary care relevant population; studies that measure ASB prevalence and risk factors; and studies from the Organization for Economic Co-operation and Development member countries. Exclusion criteria include: studies from inpatient hospital settings (including the emergency department); studies exclusively including people who are pregnant, who have urinary catheters, who are post renal transplant or who have structural urological abnormalities; animal studies; laboratory studies; studies published before 1990; and studies not written in English. Searches were conducted in CINAHL, Embase and Medline using MeSH and free text words adapted for each database including terms for bacteriuria AND asymptomatic disease. The Cochrane Collaboration Covidence platform is being used for the management of screening and assessment of studies. Two authors are independently completing screening, data extraction and quality assessments. Results The initial search identified 3891 studies. After screening, 685 are currently undergoing full text review. Overall findings will be reported in a narrative synthesis. We will describe the studies identified, including how ASB has been defined within each of the studies. If sufficient data are available we will complete a meta-analysis. Using standard meta-analysis methods we will generate forest plots showing prevalence and 95% CIs for each study. If possible, we will estimate pooled prevalence of ASB from the reported prevalence of eligible studies, by age group and gender. Conclusions The results of this review may highlight where new evidence around ASB prevalence and risk factors relevant to a UK primary care population is needed.

Prevalence of asymptomatic bacteriuria and its antibacterial susceptibility pattern among pregnant women

Background and Aim: The condition of asymptomatic bacteriuria in pregnancy is common, and up to 40% of women developing pyelonephritis in pregnancy may suffer low birth weight and membrane’s premature rupture. The present study intended to investigate the incidence of asymptomatic bacteriuria and its antibacterial susceptibility pattern among pregnant women. Patients and Methods: This cross-sectional study was carried out on 183 pregnant women attending Obstetrics and Gynecology Department of Ayub Teaching Hospital, Abbottabad from December 2021 to May 2022. Pregnant women with asymptomatic bacteriuria attended the ANC services and willing to provide written consent were enrolled. Standard bacteriological procedures were followed for bacterial isolates identification using biochemical tests, colony characteristics, and Gram-staining. Kirby- Bauer disk diffusion technique was used for Antimicrobial susceptibility test on Muller-Hinton agar medium and Clinical Laboratory Standard Institute guidelines was used for interpretation of zone of inhibition diameter. Midstream urine samples were collected from each study participant and standard microbiological methods to culture urine, identify the pathogen, and conduct sensitivity tests. Data analysis was done in SPSS version 27. Results: The prevalence of asymptomatic bacteriuria was 14.2% (n=26) among pregnant women.

Asymptomatic bacteriuria in pregnant Nigerian women at the Lagos University Teaching Hospital, south west Nigeria

Background: Dipstick urinalysis is a handy and cost effective method for the early detection of asymptomatic bacteriuria. Asymptomatic bacteriuria occurs in 2-10% of pregnancies and has been associated with low birth weight and preterm delivery in pregnant women if untreated. Objective: To determine the incidence of asymptomatic bacteriuria in pregnancy, the distribution of infecting organisms and the antibiotic sensitivity pattern in pregnant Nigerian women attending the antenatal clinic of the Lagos University Teaching Hospital, Idi- Araba, Lagos. Methodology: This was a prospective study. The study population were 201 consecutive asymptomatic pregnant women, who attended the antenatal clinic of LUTH for booking between 1st July and 31st December, 2021. Two consecutive urine samples were collected and analysed for microscopy, culture and sensitivity and urinalysis. The outcomes of interest were prevalence of asymptomatic bacteriuria at LUTH, bacterial isolates, and their antibiotic sensitivity pattern. Results: The mean age of the population studied was 31years ± 4.56SD. The mean gestational age was 23.8 ± 5.39 SD with a range of 11-34 weeks; and majority of the participants (65.7%) were recruited at gestational ages between 14 and 26 weeks. The prevalence of asymptomatic bacteriuria in this study was 13.9%. The commonest isolated organism was klebsiella (46.4%) followed by Escherichia coli (21.4%). Ceftazidime, ofloxacin, and gentamycin showed good overall sensitivity with 92.9%, 89.3%, and 67.9%% respectively. From the results of urinalysis, nitrites showed a sensitivity of 48.3% and specificity of 98.2% with a positive predictive value of 83.3% while presence of bacterial cells on urine microscopy showed sensitivity of 31.2%, specificity of 85% and a positive predictive value of 27%. Conclusion: The incidence of asymptomatic bacteriuria in this study was considerably high and therefore, there may be need to consider introduction of routine urine culture at booking or in the second trimester.

Prevalence of Asymptomatic Bacteriuria (ASB) in Pregnant Women in India: A Systematic Review and Meta-Analysis.

Asymptomatic bacteriuria is prevalent during pregnancy. If it goes undetected, it can lead to urinary tract infection with severe maternal and neonatal complications. Until date, India does not have any guidelines to test for ASB during pregnancy. To estimate the pooled prevalence of asymptomatic bacteriuria in pregnant women at national level in India. We searched Medline, Embase, Web of Science, and Google Scholar using search strategy with keyword. Two authors independently assessed the eligibility of study. The checklist of the JBI was used for evaluating the quality of reporting. The extracted data were analyzed, and the results were reported using a random-effects model with 95% confidence interval (CI). Subgroup analysis was conducted for zones of India, parity and trimester. Publication bias is reported as funnel plot. Pooled prevalence of asymptomatic bacteriuria among pregnant women in India is 13.5% [CI 11.1; 15.8]. Subgroup analysis based on the various geographic zones of the country the pooled prevalence ranged from 9.2% in central zone to 14.8% in south zone. Distribution of prevalence of ASB as per parity was approximately identical. The prevalence of ASB was found to be high in third (21.8%). The prevalence of ASB is found to be high among Indian pregnant women, especially in third trimester. It is therefore recommended for guideline to screen and treat every pregnant woman for ASB to prevent further complications.

РОЛЬ БАКТЕРИОЛОГИЧЕСКОГО И БАКТЕРИОСКОПИЧЕСКОГО ИССЛЕДОВАНИЯ МОЧИ В ДИАГНОСТИКЕ ИНФЕКЦИЙ МОЧЕВЫХ ПУТЕЙ

The article presents the results of comparative urine studies of patients with pyelonephritis and patients without signs of UTI. The results of bacterioscopic and bacteriological examination of urine of 69 patients with pyelonephritis and 27 without UTI were analyzed. A high prevalence of negative urine culture in pyelonephritis (59.4%) was revealed, as well as the prevalence of negative culture in the presence of bacteriuria detected microscopically in urine sediment (37.5%). In patients without pyelonephritis, a bacteriological study showed bacterial growth in 66.7% of cases, which indicates the prevalence of asymptomatic bacteriuria in urological patients. Literature data on diagnostic problems and possible causes of false negative results of bacteriological examination in UTI are analyzed. One of the reasons for these results are the disadvantages and limitations of standard bacteriological culture. The need to introduce new advanced methods of bacteriological research into clinical practice is urgent.

Prevalence and Plasmid Profiles of Enterobacteriaceae Isolates Obtained from Individuals with Asymptomatic Bacteriuria in Okada, Edo State, Nigeria

Asymptomatic bacteriuria (ASB) is the presence of bacteria in apparently healthy individuals. Although, the prevalence varies widely with age, gender, and the presence or absence of genitourinary abnormalities, the detection of pathogenic bacteria in urine constitutes firm evidence of infection. The objectives of this study were to isolate members of the family Enterobacteriaceae from urine samples of research participants, and to determine the antibacterial susceptibility and plasmid profiles of the isolates. A total of 122 mid-stream urine samples consisting of 72 male and 50 female participants from selected primary and secondary schools were collected. The age of the participants used in this study ranged between 4 years to 19 years old. Isolates were cultured on MacConkey agar and Cysteine lactose electrolyte deficient agar and then incubated for 24 hr at 37 °C. The overnight culture was then subjected to antibiotic susceptibility testing using the disk diffusion test as described by Kirby-Bauer. Thereafter, plasmid analysis was carried out. The statistical package used to analyze the samples was IBM SPSS v23 to cover the calculations for the chi-square, student t-test, and analysis of variance. The frequency of bacterial isolates with respect to age were obtained, as follows: 4–8 (9.0%), 9–13 (16.4%), 14–18 (2.5%) and >19 (1.6%). The prevalence of the four (23; 63.9%) Enterobacteriaceae isolate groups were: Escherichia coli (36.1%), Citrobacter species (11.1%), Klebsiella species (8.3%) and Enterobacter species (8.3%) while non Enterobacteriaceae (13) was 36.1%. A prevalence of 25.9% of ASB was reported in this study where the percentage occurrence of bacteria isolates showed high prevalence in the male participants, at 17.2% compared to the 12.3% reported for the female participants. The antibiogram showed that all isolates were susceptible to Cefprozil except isolates belonging Klebsiella species that showed resistance to the antibiotic. Citrobacter species and Klebsiella species isolates were susceptible to Ofloxacin while Enterobacter species isolates was only susceptible to Cefixime. The percentage figures from resistant plasmid profile analysis indicated that Cefuroxime, Cefprozil and Ofloxacin showed relatively good susceptibility profile against the nine bacterial isolates that were subjected to the analysis. Resistance After plasmid curing was majorly chromosomally-borne. From this research, the prevalence of ASB was found yo be high in Okada, with the infection being higher in males having Escherichia coli as the commonest bacterial isolate. Hence, there is need for early routine evaluation as well as detection of this silent infection for prompt referral and intervention.

Investigation of preoperative asymptomatic bacteriuria as a risk factor for postvertebroplasty infection.

Postvertebroplasty infection (PVI) is a catastrophic complication after vertebroplasty (VP). Although the urinary tract has been considered as a source of infectious pathogens, whether asymptomatic bacteriuria (ASB) is a risk factors for PVI remains unknown. This retrospective study included 716 patients (207 males; 509 females) treated with VP for osteoporotic vertebral fractures in a single medical center between May 2015 and December 2019. Clinical symptoms, urinalysis results, and culture data were collected preoperatively to identify patients with ASB. The primary outcome was PVI at the index level during follow-up. Demographic data and laboratory test results were compared between the PVI and non-PVI groups. The mean age of the cohort was 78.6 ± 9.6 (range, 63-106). The prevalence of ASB was 14.1%, with female predominance (63.4%). The overall PVI rate was 1.26% (9/716). The PVI group had more patients with ASB (4/9, 44.4%) than did the non-PVI group (97/707, 13.7%) (p = 0.027). The rate of ASB treatment was similar between the PVI and non-PVI groups (25% vs. 23.7%, respectively). No case of PVI was caused by the urine culture pathogen. Multivariate analysis identified the following risk factors for PVI: ASB (odds ratio [OR], 5.61; 95% CI, 1.14-27.66; p = 0.034), smoking (OR, 16.26; 95% CI, 2.58-102.65; p = 0.003), and malignancy (OR 7.27; 95% CI, 1.31-40.31; p = 0.023). ASB was not uncommon among patients admitted for VP and should be considered a marker of relatively poor host immunity. Preoperative ASB, a history of malignancy, and smoking were identified as significant risk factors for PVI.

Evaluation of Diagnostic Methods for Asymptomatic Bacteriuria (ASB) During Pregnancy

Asymptomatic bacteriuria (ASB) is the existence of bacteria in a patient's properly gathered urine who has no obvious symptoms of a urinary tract infection, which is common in females, with the prevalence rate of 2-11%, ASB during pregnancy is influenced by a range of factors including; mechanical compression, changes in the immune and renal systems, if ASB untreated, it can lead to cystitis and pyelonephritis. Our aim is to evaluate the sensitivity and specificity of the screening tests compared with the culture method for detection of ASB during pregnancy, and to identify the most common etiologic agents of ASB in pregnant women. An analytical cross- sectional study was carried out on 110 pregnant women, selected using nonprobability sampling methods their age between 18-45year- old with no signs and symptoms of urinary tract infections (UTIs). Clean-catch Midstream urine specimen from each participant was collected and submitted for routine analysis by dipstick to detect leukocyte esterase, nitrite reductase tests and microscopic examination to detect pyuria (pus cells), as well as urine culture, and biochemical test. About 14.5% of pregnant women were positive for ASB, the most prevalent bacterium Escherichia coli (37.5%) followed by Klebsiella pneumoniae (18.7%). There was no significant association between age, parity, gestation, recurrent urinary tract infections, Diabetes mellitus, hypertension and ASB. For screening tests; the nitrite test was more specific (98.9%) than leukocyte esterase and pus cells, on the other hand, pus cell detection was more sensitive (81.2%) than the other tests for detection of ASB. The prevalence of ASB was relatively high, no one used routine screening tests revealed both high sensitivity and specificity. So, urine culture remains the gold standard method for detection of ASB in pregnant women.

Prevalence of asymptomatic bacteriuria among pregnant women and changes in antibiotic resistance: a 6-year retrospective study

Objective: Asymptomatic bacteriuria (ASB) during pregnancy is a risk factor for development of urinary tract infections and pyelonephritis, which can lead to maternal and foetal consequences. This study aimed to determine the prevalence of ASB during pregnancy, the most common causative pathogens and their resistance patterns. Methods: A retrospective analysis was performed using microbiology laboratory data from urine sample cultures from pregnant women collected at our University hospital over a 6-year period (2014–2019). Identification and susceptibility testing were performed using standard microbiology procedures based on British Society of Antimicrobial Chemotherapy and European Committee on Antimicrobial Susceptibility Testing. Results: From a total of 18,938 urine samples, 1522 (8.04%) were positive for bacteriuria, the most common isolates were Escherichia coli and Coliform (lactose fermenters) ( n = 1171, 76.9%), followed by Enterococcus faecalis and other enterococci ( n = 191, 12.5%). In 2019, the resistance of E. coli was 56.8%, 25.3% and 4.7% to amoxicillin, trimethoprim and gentamicin, respectively, with an increasing pattern of resistance to trimethoprim and gentamicin from 2014 to 2019. The resistance rates to nitrofurantoin were 1% and 5.5% for E. coli and Group B Streptococcus, respectively. Conclusion: Our study shows the trends of antimicrobial resistance in this vulnerable group and will help confirm treatment effectiveness and direct guideline recommendations locally and internationally. Level of Evidence: 2b

Prevalence of asymptomatic Bacteriuria among Pregnant Women in Sirte City (Libya).

Asymptomatic bacteriuria (ASB) is known as significant presence of pathogenic bacteria more as 105 CFU/ml in urine culture of pregnant women without any symptoms indicate of urinary tract infections. Which is may lead to serious complications on health of a pregnant woman, and the fetus if left untreated. The purpose of this study was designed to find the prevalence of asymptomatic urinary tract infection (AUTI) among pregnant women, and also to determine the antibacterial susceptibility of the isolates to various antibiotics to reduce risk factors in pregnancy. However, little is known about asymptomatic bacteriuria in pregnancy in Libya, namely in Sirte city. A total of 265 samples were collected in 7 months study involving women attending antenatal clinics in Sirte City-Libya, mid-stream urine samples were collected for microscopically examination. A colony culture growth were identified by biochemical tests and conventional antibiotic susceptibility tested in microbiology laboratory. Isolates were identified and tested against commonly used antimicrobial drugs using Kirby Bauer disc diffusion method. The prevalence of 265 pregnant women in different age groups were enrolled in this study, only 76 (28.7%) pregnant women had bacteriuria. The organism isolated from the urine sample according to the frequency of occurrence was Escherichia coli 32(42.1%), Coagulase negative Staphylococcus 11 (14.4%), Staphylococcus aureus 9(11.8%), Klebsiella Pneumoniae 9(11.8%), Streptococcus agalactiae 8 (10.5%), Enterococcus spp 5(6.6%), Proteus mirabilis 2(2.6%), respectively. The overall prevalence of asymptomatic bacteriuria among pregnant women in the study area was not high, but need to be taken on consider reducing risk of infections. The presence of asymptomatic bacteriuria and their antibiotic susceptibility test results should be taken into consideration during the management of pregnant women who are visiting antenatal care clinic; because there was high resistance to the most commonly used antibiotics. Routine urine culture and antimicrobial sensitivity for antenatal women should be carried out to detect asymptomatic bacteriuria to treat early infections, to prevent any serious complication associated with pregnancy.