Risk Factors For Asymptomatic Bacteriuria Research Articles

Prevalence, resistant pattern and associated risk factors of asymptomatic bacteriuria among antenatal clients in a municipal hospital in Ghana

Prevalence, resistant pattern and associated risk factors of asymptomatic bacteriuria among antenatal clients in a municipal hospital in Ghana

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.

Associated Risk Factors for Asymptomatic Bacteriuria in Pregnant Women Visited Antenatal Clinic in Lahore, Pakistan

Background: Asymptomatic bacteriuria is the occurrence of bacteria in the urine sample without any clinical symptoms. The odds of asymptomatic bacteriuria increase due to the hormonal growth during pregnancy. Methodology: The data was collected from a sample of size 167 pregnant women using self-structured questionnaire. The questionnaire was based on two sections. The questionnaire was tested using Cronbach alpha. The data was collected using convenient sampling. The frequency distribution of the risk factors was given. The binary logistic regression analysis was performed to access the major risk factors that enhance the odds for asymptomatic bacteriuria in pregnant women. Results: The past history of UTI was seen as a significant risk factor. The overall incidence of asymptomatic bacteriuria was found in 22 pregnant women and among these, approximately 9% had past history of UTI. About 44.9% of the pregnant women showed a past history of UTI. Conclusion: Most of the pregnant women fall in the age group 26-32 years. The significant factor is age group for asymptomatic bacteriuria. Advancement in age enhance the odds for the asymptomatic bacteriuria. History of UTI is found as a significant risk factor. Keywords: Asymptomatic bacteriuria, pregnancy, infections,

Urodynamic risk factors of asymptomatic bacteriuria in men with non-neurogenic lower urinary tract symptoms.

To investigate the prevalence of asymptomatic bacteriuria (ASB) in middle-aged and older men with non-neurogenic lower urinary tract symptoms (LUTS) and clarify urodynamic factors related to the presence of ASB. We retrospectively reviewed the clinical data of men with LUTS who underwent urine culture examination, LUTS severity assessment, and urodynamic studies. The patients were allocated into two groups (the ASB + LUTS and LUTS-only) according to presence or absence of ASB. The patients' characteristics and urodynamic factors related to the development of ASB were assessed using univariate, binomial logistic regression, and receiver-operating characteristic (ROC) curve analyses. Of 440 men, 93 (21.1%) had ASB. Parameters related to voiding functions, such as maximum flow rate, post-void residual urine volume, bladder voiding efficiency (BVE), and bladder contractility index (BCI), were significantly reduced in the ASB + LUTS group, while bladder outlet obstruction index was not different between the groups. Binomial logistic regression analysis showed that the presence of diabetes, lower BCI, and lower BVE were significantly associated with the presence of ASB. In addition, ROC analysis identified 55% as the optimal cutoff value of BVE for the presence of ASB, with a sensitivity of 84% and specificity of 83%. ASB was found in > 20% of men with non-neurogenic LUTS and was associated with decreased bladder contractility and decreased BVE. BVE could predict presence of ASB with high sensitivity and specificity.

Evaluation of socio- demographic risk factors for asymptomatic bacteriuria in pregnancy

Background: Asymptomatic Bacteriuria in pregnancy though common often goes undiagnosed till overt U.T.I. occurs. It leads to various maternal and fetal complications. Many factors influence its occurrence. The aim of the study was to evaluate socio-demographic risk factors of asymptomatic bacteriuria. Methods: A hospital based observational study done over one year in the antenatal clinic of a tertiary care hospital. Urine of all the pregnant women was sent for complete microscopy and culture &amp; sensitivity. Socio-demographic profile of all women was noted and data analysed. Results: Of the 450 women included in study, 8.22% had asymptomatic bacteriuria. It was significantly more in the less educated, in those residing in rural and semi-urban areas or belonging to socioeconomic group IV. Conclusion: All pregnant women must be universally screened for asymptomatic bacteriuria. In case it is not feasible, women with high risk factors should be identified and selectively screened.

English

Asymptomatic bacteriuria can lead to urinary tract infections in as many as 20% of pregnant women. Asymptomatic bacteriuria in pregnancy can also lead to preterm births and low birth weights. The objective of this study was to profile uro-pathogens and describe the population-based prevalence, the antimicrobial sensitivity pattern, and ascertain the risk factors for asymptomatic bacteriuria among pregnant women attending the antenatal clinic of Ho Teaching Hospital, in Ghana. Urine samples were cultured, isolates identified and antibiotic sensitivity testing was done using the Clinical and Laboratory Standard Institute (CLSI) guidelines. 46 (13.7%) out of 335 pregnant women had asymptomatic bacteriuria. The most frequently isolated bacteria were Pseudomonas species (26.1%) followed by Escherichia coli (21.7%). All isolates (n=46; 100%) were resistant to Augmentin whereas 87% of the isolates (n=40) were susceptible to Gentamicin. However, most of the isolates were multi-resistant to antibiotic drugs. No education (p=0.019) and first trimester (p=0.046) of pregnancy were risk factors for asymptomatic bacteriuria. Pseudomonas aeruginosa was the most frequent organism isolated. All the uro-pathogens were resistant to Augmentin, while high rates of resistance to Tetracycline, Amikacin, Norfloxacin, and Levofloxacin were observed. The study reveals that asymptomatic bacteriuria was significantly associated with the first trimester of pregnancy and having no education. &nbsp; Key words: Bacteriuria, urinary tract infections, prevalence, Ghana, Ho Teaching Hospital, antimicrobial resistance.

Epidemiology and risk factors for ureteral stent-associated urinary tract infections in non-transplanted renal patients: a systematic review of the literature

Pathophysiology and risk factors for Ureteral Stent-Associated Urinary Tract Infection (USAUTI) have been poorly investigated. This situation results in highly diverse practices regarding USAUTI prevention, diagnosis and treatment. The aim of the present study was to describe the epidemiology and risk factors for USAUTI in non-transplanted patients. We conducted a systematic literature review based on a comprehensive PubMed® bibliographic strategy, between October 1998 and March 2020. The methodological quality of the studies included was analyzed according to dedicated grids. The main endpoints were the correlation between different potential risk factors and infection ureteral stent-associated urinary tract infection or colonization rate. Conclusions and their level of evidence were reported on the basis of a critical analysis of the best available scientific evidence. This work has been submitted to a national review, which enabled the potentially divergent opinions of experts to be collected, thereby ensuring adequate quality of data. Twenty-six studies out of the 505 articles identified, were included in the final analysis. Staphylococcus spp, E. coli, Klebsiella spp, Pseudomona aeruginosa, Enterococcus spp. and Candida spp. were the microorganisms most often responsible for asymptomatic bacteriuria (ABU) or USAUTI. Longer indwelling time, diabetes mellitus, female gender, chronic renal failure, diabetic nephropathy and cancer were identified as risk factors for ABU and ureteral stent colonization. No specific risk factor for UTI was identified in the literature studied. A causal relationship between ureteral stent colonization and USAUTI or urosepsis remains to be demonstrated.

Prevalence and Risk Factors of Asymptomatic Bacteriuria Among Apparently Healthy Women in Lagos, Nigeria

Asymptomatic bacteriuria is the presence of bacteria in the urine without the accompanying symptoms of urinary tract infection. The prevalence of asymptomatic bacteriuria is reported to increase with age, with the highest prevalence seen in postmenopausal women. However, data on the general prevalence of ASB in African women is not available. The main objective of this study was to evaluate the prevalence of asymptomatic bacteriuria and its associated risk factors among women in Lagos, Nigeria. This was a cross-sectional study involving 162 apparently healthy women at the outpatient clinic of the Lagos University Teaching Hospital, Lagos, Nigeria. A questionnaire was used to collect information on socio-demographic factors and hygienic practices, and midstream urine was collected to assay for significant bacteriuria. The result of the study showed an asymptomatic bacteriuria prevalence of 27.8%, with the prevalence higher in premenopausal women than in postmenopausal women, albeit not statistically significant. This prevalence was not significantly associated with educational status, marital status, ethnicity, past treatment of urinary tract infection, type of product used during menstruation, or even the method of washing the vagina. Considering that the treatment of asymptomatic bacteriuria is only recommended in pregnant women, and the prevalence of asymptomatic bacteriuria is similar among pregnant and non-pregnant women, we recommend that women be screened for asymptomatic bacteriuria immediately upon pregnancy, and that screening for asymptomatic bacteriuria be made one of the routine screening tests for pregnant women in Nigeria.

Preoperative asymptomatic bacteriuria in patients undergoing total joint arthroplasty in South Africa

ABSTRACT BACKGROUND: Periprosthetic joint infections (PJIs) are a leading cause of revision for total hip arthroplasty (THA) and total knee arthroplasty (TKA), worldwide. Asymptomatic bacteriuria (ASB) is an independent risk factor for PJIs; however, a paucity of data relevant to developing countries exists. The aim of this study was to describe the prevalence of preoperative ASB and the subsequent incidence of PJIs in patients undergoing total joint arthroplasty (TJA) in South Africa. METHODS: We retrospectively reviewed primary THA and TKA patients. All patients were screened for ASB preoperatively. Patients with positive urinalysis for ASB were identified and treated prior to surgery (treated-ASB). The primary outcome was ASB prevalence and the incidence of PJIs and other perioperative complications. Secondary outcomes included risk factors for ASB and subsequent PJIs in treated-ASB patients, respectively, compared to those with no evidence of ASB (non-ASB). Lastly, we aimed to compare the infective microorganisms cultured from preoperative urinalysis and perioperative sampling of PJIs. RESULTS: We included 179 patients (67 THA; 80% female) with mean follow-up of 2.45 years. ASB prevalence was 22% (n = 39). Patients older than 70 years were 3.5 times more likely to have ASB compared to younger patients (p = 0.005). The prevalence of ASB was 22% (n = 10) for human immunodeficiency virus (HIV) positive and 22% (n = 29) for HIV-negative patients (p = 0.084). PJI incidence was 8% (n = 3) in the treated-ASB and 1% (n = 1) in non-ASB. Treated-ASB patients had an 11.6-fold increased likelihood of PJIs than non-ASB patients (p = 0.046). pJi microorganisms cultured did not correlate to isolates from urine cultures. CONCLUSION: The prevalence of ASB in a TJA population in South Africa is 22% which is higher than reported findings worldwide. Although the value of preoperative antibiotic therapy for ASB remains controversial, there is a role for routine urinalysis preoperatively to identify patients predisposed to PJI. This is of specific significance in the management of HIV-positive patients and in developing countries to guide healthcare providers in resource-constrained environments. Level of evidence: Level 2. Keywords: total hip arthroplasty, total knee arthroplasty, asymptomatic bacteriuria, periprosthetic joint infection, developing country

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

Gauging the Risk Factors for Asymptomatic Bacteriuria in Type-2 Diabetic Women: A Case-Control Study.

BackgroundThere is conflicting literature pertaining to the risk factors of asymptomatic bacteriuria (ASBU) in diabetic women. ASBU is a well-established risk factor for frequent urinary tract infections (UTIs), and the risk factors that predispose diabetic women to ASBU should, therefore, be evaluated. ObjectivesThis study aims to discern these aforesaid risk factors in type-2 diabetic women, define a population subset at particularly high risk for ASBU, and gauge the efficacy inherent in adhering to an antibiotic regimen in combatting ASBU. MethodsAn analytical, case-control study was conducted at the Diabetic Clinic of the Holy Family Hospital (HFH), Rawalpindi, Pakistan. The participants included were type-2 diabetic women reporting to the clinic for routine follow-up. Six hundred and sixty-seven urine samples from these type-2 diabetic women were evaluated. Positive cases were those in which patients were diagnosed with ASBU according to the guidelines, while those with no ASBU constituted the control group. Common risk factors for UTI were excluded in both groups. Age, socioeconomic status, hygiene practices, and contraceptive use were matched between cases and controls. ResultsNineteen percent of type-2 diabetic women presented with ASBU in our study. The significant risk factors for ASBU were a higher HbA1c level (OR 1.97), more years since the initial diagnosis of diabetes (OR 1.49), a prior UTI history (OR 2.49), excessive antibiotic use (OR 2.72), sodium-glucose cotransporter-2 (SGLT2) inhibitor use (OR 1.75), and proteinuria (OR 1.88) in the multivariate model. Body mass index (BMI), age of the patients, pyuria, and voiding dysfunction manifested no association with ASBU. Antibiotic use was significantly associated with the type of bacterial species precipitating the ASBU. ConclusionThe clinicians must keep in mind the association between the various patient parameters and ASBU, especially in prescribing antibiotics to diabetic women. More studies are needed to further elaborate on these risk factors and revise the patient management in at-risk cases for ASBU and UTIs.

Asymptomatic Uropathogenic Bacteriuria Among Pregnant and Non-pregnant Women at St Luke’s Hospital Anua, Offot Ukwa District Uyo: A Reassessment Case-Control Approach

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^st, 2^nd and 3^rd 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.

Clinical Profile of Asymptomatic Bacteriuria in Type 2 Diabetes Mellitus: An Eastern India Perspective.

Introduction:Asymptomatic bacteriuria (ASB), believed to precede symptomatic urinary tract infection (UTI) in diabetes mellitus, has geographical variation in microbial pattern and risk factors. However, data from the Eastern part of India are still lacking.Materials and Methods:A prospective longitudinal study was performed over 80 otherwise healthy type 2 diabetes patients with a follow-up for one year to (1) estimate the prevalence of ASB and its association with age, gender, duration of diabetes, and renal and glycemic status; and (2) identify the antibiotic sensitivity pattern of uropathogens as well as evaluate the usefulness of microbial pattern as a predictor of symptomatic UTI.Results:ASB was prevalent in 21.25% of type 2 diabetes population in our study. Klebsiella sp emerged as the commonest cause among males. The only risk factor for ASB was found to be long-standing type 2 diabetes. There was no association with age, gender, or recent glycemic status. Bacteriuric patients with worse baseline HbA1C values were at greater risk of UTI. Female diabetic patients with ASB due to Escherichia coli had significantly greater risk of developing UTI within one year.Conclusion:A large-scale prospective study reproducing similar findings will genuinely obviate the need to review recommendations on screening of ASB due to E. coli in females with long-standing diabetes and poor glycemic control. Early adoption of stringent HbA1C lowering strategy and measures to improve genital hygiene can help prevent symptomatic UTI in these patients.

Asymptomatic Bacteriuria and Anti-Microbial Susceptibility Patterns among Women of Reproductive Age. A Cross-Sectional Study in Primary Care, Ghana.

Background: Asymptomatic bacteriuria (ASB) poses serious future clinical repercussions for reproductive women. The study determined the prevalence of asymptomatic bacteriuria along with anti-microbial susceptibility patterns among women of reproductive age in a primary care facility. Method: The study recruited a total of 300 women of reproductive age attending the Tetteh Quarshie Memorial Hospital at Akuapem-Mampong, Ghana, between January and March 2018. Questionnaires were administered to obtain demographic data and predisposing risk factors of ASB. An early-morning midstream urine sample was collected from participants. Urinalysis, urine culture, and anti-microbial susceptibility testing were performed. Results: The mean age of participants was 25.43 years. The overall prevalence rate of ASB was 40.3%. The prevalence was higher among pregnant women compared to non-pregnant women (33.3% vs. 7.0%). The most common bacterial isolate was E. coli (47.0%) followed by Proteus spp. (36.4%), Klebsiella spp. (8.3%), and E. faecalis (8.3%). Leukocyturia (35.0%) followed by nitrate (30.0%) were the most common urine abnormalities identified on dipstick urinalysis. Most bacteria isolates showed increased resistance to ampicillin (95.04%) and tetracycline (95.04%) while most of the bacterial isolates were sensitive to levofloxacin (94.35%). Demographic characteristics including age (p < 0.001), educational level (p < 0.001), residency (p = 0.001), and marital status (p = 0.005) were significantly associated with ASB. Lifestyle characteristics such as sexual status (p = 0.001) and frequency of washing of intimate parts after sexual intercourse (p < 0.001) were also significantly associated with ASB. Conclusion: Asymptomatic bacteriuria, particularly E. coli and Proteus spp. are prevalent in the urine of pregnant women living in Akuapem-Mampong municipality. Hence public education along with early screening of ASB is essential to reducing future risk of reproductive health complications. Future studies are required to assess the impact of public health on the rate of bacterial infections.

Prevalence and risk factors of asymptomatic bacteriuria among children living with HIV in Lagos, Nigeria.

IntroductionHIV/AIDS has gradually become a chronic disorder following the success of combination chemotherapy. As a result of the persisting immune deficiency, certain risk factors predispose affected individuals to infections. The aim of the study was to determine the prevalence and identify risk factors of asymptomatic bacteriuria among HIV infected children.Methodsthis was a case control study conducted at the Lagos University Teaching Hospital from July 2010 to June 2011.Eighty-five children living with HIV were consecutively selected from the HIV clinic of the Lagos University Teaching Hospital and compared with 85 age and sex matched HIV negative controls for the occurrence of asymptomatic bacteriuria. Mid-stream urine samples were obtained from the participants and the samples were analyzed for microscopy, culture and sensitivity. Demographic and clinical data was obtained from the caregivers and clinical notes respectively. Data were analyzed utilizing SPSS version 17.Resultsthe prevalence of asymptomatic bacteriuria was 24.7% among children living with HIV and 8.2% among un-infected children (p value 0.004). The stage of the disease, CD4 count, sex as well as age were risk factors for asymptomatic bacteriuria among children living with HIV.Conclusionasymptomatic bacteriuria is a prevalent problem among children living with HIV infection and urinary screening should be routine in the work up of febrile children living with HIV.

Bacterial Etiology, Antibiotic Sensitivity Pattern and Risk Factors for Asymptomatic Bacteriuria during Pregnancy: Experience in a Tertiary Care Hospital

Background: Urinary tract infections (UTIs) are common during pregnancy. Untreated asymptomatic bacteriuria (ASB) during pregnancy may cause serious complications including pyelonephritis and delivery of premature or low-birth-weight infants. This study aimed to assess the risk factors for asymptomatic bacteriuria, bacterial agents and their antibiotic susceptibility pattern in pregnant women attending in Combined Military Hospital (CMH), Dhaka.Methods: This cross-sectional study was conducted in a total of 1540 pregnant women with no signs and symptoms of UTI from October 2013 to March 2015. Clean catch mid-stream urine samples were collected from all study participants using sterile containers. Urine samples were cultured using standard bacteriological methods. Identification of suspected colonies and antibiotic sensitivity testing were done. Patients having ASB were further evaluated to find out associated risk factors.Results: Out of 1540 pregnant women, 254 (16.5%) had asymptomatic bacteriuria (Colony forming unit &gt;105/mL).The most frequently isolated bacteria were Escherichia coli (E. coli) (50.4%), followed by Klebsiella (24.0%). The antibiotic sensitivity rate of bacterial isolates were highest for imipenem and amikacin. Among different associated conditions, anemia (16.5%), gestational diabetes mellitus (GDM) (10%) and past history of UTI (5.1%) were found to be the most frequent factors associated with increased prevalence of ASB.Conclusion: In this study, the prevalence of ASB was high among pregnant women with anemia, GDM and past history of UTI. E. coli was the most common organism causing ASB, which is less susceptible to conventional oral antibiotics but more susceptible to imipenem and amikacin. So, careful drug selection is required for successful outcome in ASB.Birdem Med J 2016; 6(2): 79-83

Diabetes Mellitus has no Significant Influence on the Prevalence of Antenatal Asymptomatic Bacteriuria.

Diabetes is a known risk factor for asymptomatic bacteriuria (ASB). However, the influence of diabetes on antenatal ASB was previously not addressed. The prevalence of ASB, effect of risk factors and type of isolates and susceptibility patterns were studied in diabetic pregnancy. A total of 311 pregnant women were recruited for this study of which 103 were diabetic and 208 non-diabetic. A clean catch midstream urine samples were collected and cultured. The isolates were identified and antibiotic sensitivity was studied. The data was analysed by Chi-square test. The prevalence of ASB in diabetic pregnancy was 38.83% (40/10(3); 95% CI: 23.73 - 53.94) and in non-diabetic pregnancy was 37.98% (79/208; CI: 27.28- 48.68). The odds ratio was not significant 1.0225 (95% CU: 0.65 - 1.599; p=0.922) and associated factors such as age and gestational period had no effect. The major isolates were Escherichia coli (25.0%), Staphylococcus aureus (22.5%), Coagulase negative staphylococci (CONS) (20.00%), and Klebsiella pneumonia (20.00%) in diabetic pregnancy and CONS (31.7%), E.coli (24.0%) and K.pneumonia (16.5%) in non-diabetic pregnancy. The isolates of diabetic pregnancy showed highest susceptibility to nitrofurantoin (56.4%), gentamicin (38.5%) and cotrimoxazole (38.5%) whereas that of non-diabetic pregnancy to gentamicin (43.0%), azithromycin (32.9%) and norfloxacin (30.4). There was no significant (p<0.05) difference in the type and susceptibly of the isolates between diabetic and non-diabetic pregnancy. Diabetes has no significant influence on the prevalence of ASB in diabetic pregnancy both in terms of isolates and antibiotic susceptibility pattern.

Asymptomatic bacteriuria and associated host factors in Diabetic patients with special reference to UTI Chromagar

Introduction: To study the prevalence of asymptomatic bacteriuria (ASB) in diabetics compared to non-diabetics and to determine the associated host factors responsible for ASB in diabetics. Materials and Methods: 250 diabetics and 100 controls were enrolled in the study and were screened for ASB using semi-quantitative culture methods and UTIchrom agar. The samples were screened for glucosuria, ketonuria and pyuria. Results: ASB was more common in diabetics compared to non-diabetics(12.8% v/s 6% ) and the increase was more in female diabetics when compared to female non-diabetics(16% v/s 6.15%) whereas male counterparts did not show much difference from the non-diabetics (6.09% v/s 5.71%). There was significant influence of age, duration of diabetes, glucosuria, ketonuria, proteinuria and pyuria on the incidence of ASB in diabetics thus proving them as possible risk factors for development of ASB. E.coli was the most common organism found in both diabetic as well as non diabetic cases of ASB (40.6% and 57.14% respectively). The next frequent organisms were Klebsiella and Staphylococcus. The sensitivity pattern was similar in both the population with ASB. Culture on UTI CHROMagar yielded quicker results when compared to standard culture methods. Conclusion: ASB is almost 3 times more common in female diabetics compared to female non-diabetics whereas there is not much difference among the male counterparts. The risk factors for ASB in diabetics included age, longer duration of diabetes, poor glycaemic control and renal dysfunction indicated by proteinuria. Culture on UTI CHROMagar is an easy and faster means of identification of organisms.

Prevalence and Associated Risk Factors of Asymptomatic Bacteriuria in Ante-Natal Clients in a Large Teaching Hospital in Ghana.

Asymptomatic bacteriuria, the presence of bacteria in urine without symptoms of acute urinary tract infection, predisposes pregnant women to the development of urinary tract infections and pyelonephritis, with an attendant pregnancy related complications. To measure the prevalence of asymptomatic bacteriuria among ante-natal clients at the Korle-Bu Teaching Hospital in Ghana and its' associated risk factors. A cross-sectional study involving 274 antenatal clients was conducted over a period of 4 weeks. A face to face questionnaire was completed and midstream urine collected for culture and antimicrobial susceptibility testing. The prevalence of asymptomatic bacteriuria was 5.5%. It was associated with sexual activity during pregnancy (Fisher's Exact 5.871, p-value 0.0135), but not with sexual frequency. There were no significant associations with educational status, parity, gestational age, marital status and the number of foetuses carried. The commonest organism isolated was Enterococcus spp (26.7%) although the enterobacteriaceae formed the majority of isolated organisms (46.7%). Nitrofurantoin was the antibiotic with the highest sensitivity to all the isolated organisms. The prevalence of asymptomatic bacteriuria among ante-natal clients at this large teaching hospital in Ghana is 5.5%, which is lower than what has been found in other African settings. Enterococcus spp was the commonest causative organism. However, due to the complications associated with asymptomatic bacteriuria, a policy to screen and treat- all pregnant women attending the hospital, is worth considering.

A study of asymptomatic bacteriuria in North Indian type 2 diabetic patients

The prevalence of asymptomatic bacteriuria (ASB) in diabetic patients varies from 9 to 27 % in various studies which is certainly higher as compared to healthy individuals. The risk factors which lead to increased prevalence of asymptomatic bacteriuria in diabetic patients are immune system dysregulation, development of bladder dysfunction and prostatism. Studies have reported that ASB has a higher prevalence in diabetic individuals as compared to nondiabetics. Patients having type 2 diabetes mellitus along with age- and sex-matched controls who were hemodynamically stable were enrolled. A prospective case-control study was done. A total of 200 patients were enrolled, and they were divided into two groups, i.e. those with diabetes and nondiabetic patients (age- and sex-matched controls) without symptoms of UTI. Urine examination and biochemical investigations of the patients were done. In our study, the prevalence of ASB among the diabetic patients was significantly higher 28.2 % as compared to 7.5 % in the controls (p = 0.001). The main risk factors for asymptomatic bacteriuria in our study were female sex (p = 0.003), increased age (p = 0.007), longer duration of diabetes mellitus (p = 0.003), poor glycemic control (p < 0.001) and recent urinary tract infection (p = 0.02). There were no significant differences in the serum creatinine levels in the patients with asymptomatic bacteriuria among diabetics as compared to the culture-negative patients. The presence of ASB may be considered a marker of poorly controlled and long-standing diabetes.