Asymptomatic Bacteriuria in Pregnancy: Prevalence, Antibiotic Susceptibility, and Related Demographic Factors

Abstract

Objective:The aim of this study was to establish the prevalence of asymptomatic bacteriuria (ABU) in pregnancy. It is the most common urinary infection among pregnant women in our area.Methods:Our study was conducted in 980 pregnant women. Gestational age of each woman was less than 20 weeks. Patients with any urinary tract infection symptoms, suprapubic pain, painful and frequent urination, urinary incontinence, smelly vaginal discharge indicating prolonged or recent antibiotic use, history of kidney disease or kidney stones, or gestational diabetes were excluded from this study. Urine culture and antibiogram of mid-stream urine were performed. The pregnant women diagnosed as having bacteriuria were treated with antibiotics for 7 days.Results:There was no statistical significant association among age, gravida, parity, and sex activity in 749 pregnant women screened for ABU. Among 749, 53 pregnant women presented with ABU (7.1%). Among these 53 patients, Escherichia coli was the most frequently isolated microorganism that was detected in 36 women (69%). E. coli is sensitive to 99.3% fosfomycin and 85% cefuroxime. Klebsiella pneumoniae, the second most common microorganism, is sensitive to 86% fosfomycin and 100% cefepime and ceftriaxone. Enterococcus species, the third most common microorganism, is sensitive to 100% ampicillin and fosfomycin.Conclusion:Pregnant women should be screened for ABU. The most appropriate period for screening is between 9 and 17 weeks of pregnancy, preferably 16. Gestational age should be measured using mid-stream urine culture. Fosfomycin is the preferred treatment because it has high sensitivity rate and is safe and easy-to-use.

Keywords

• Pregnancy
• asymptomatic bacteriuria
• prevalence
• antibiotic susceptibility
• related risk factors