A study of prevalence of asymptomatic bacteriuria in pregnant women from rural areas attending to Obstetric Department in Akash Hospital, Karnataka, India

Rohini N. S.; Ravishankar S. N.; Kala K.; Rakshith N. R.

doi:10.18203/2320-1770.ijrcog20193053

Authors

Rohini N. S. Associate professor, Department of Obstetrics and Gynecology, Akash Institute of Medical Sciences and Research Centre, Karnataka, India
Ravishankar S. N. Professor and HOD, Department of Internal Medicine, Akash Institute of Medical Sciences and Research Centre, Karnataka, India
Kala K. Professor and HOD, Department of Obstetrics and Gynecology, Akash Institute of Medical Sciences and Research Centre, Karnataka, India
Rakshith N. R. UG medical student, JSS Medical College, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20193053

Keywords:

Asymptomatic bacteriuria, Pregnancy, Screening tests

Abstract

Background: Asymptomatic bacteriuria (ASB) in pregnancy is a significant risk factor for developing upper urinary tract infection and pyelonephritis which is associated with significant maternal and fetal risks. The aim of this study was to know the prevalence of asymptomatic bacteriuria in pregnancy, to identify the organisms and their antibiotic susceptibility patterns and to formulate a single or combined rapid screening method as an acceptable alternative to urine culture.

Methods: A total of 375 pregnant women aged between 18 to 45 years were included in this study. Clean catch mid-stream urine samples were collected. Screening tests done were gram staining of uncentrifuged urine, pus cell count, nitrite test and leukocyte esterase test. Identification of pathogens and antibiotic sensitivity tests were performed as per standard urine culture and sensitivity methods.

Results: Out of the 375 pregnant women, 31 (8.4%) had significant bacteriuria. High percentage of women with ASB were primigravidas (51.38%) and in 2^nd trimester (43.86%). The most common organism isolated was E.coli (56.14%). In screening tests, gram staining of uncentrifuged urine had a sensitivity of 85.71%. Sensitivity of 71.42% was found in Nitrite and leucocyte esterase tests. However, the combination of these two tests, with either test positive, showed sensitivity and negative predictive value of 90.47% and 99.09% respectively.

Conclusions: Early detection and treatment of ASB in pregnancy can prevent complications. ASB can be identified by simple and combined rapid screening methods and urine culture along with antibiogram. Therefore, screening and treatment of ASB may be incorporated as routine antenatal care for safe motherhood and healthy newborn.

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References

Cram LF, Zapata MI, Toy EC, Baker B. Genitourinary infections and their association with preterm labor. Am Family Physician. 2002;65:241-8.

Girishbabu RJ, Srikrishna R, Ramesh ST. Asymptomatic bacteriuria in pregnancy. Int J Biol Med Res. 2011;2(3):740-2.

Nicole LE. Screening for asymptomatic bacteriuria in pregnancy. In: Nicole LE, eds. Canadian Guide to Clinical Preventive Health Care. Ottawa: Health Canada. 1994:100-106.

Gilstrap LC, Ramin SM. Urinary tract infections during pregnancy. Obstet Gynaecol Clin N Am. 2001; 28(3):581-91.

Lavanya SV, Jogalakshmi D Asymptomatic bacteriuria in antenatal women. Indian J Med Micribiol. 2002;20:105-6.

DeIzell JE, Lefevre ML. Urinary tract infections during pregnancy. Am Fam Physician. 2000;61(3):713-21.

Jayalaxmi J, Jayaram VS. Evaluation of various screening tests to detect asymptomatic bacteriuria in pregnant women: IJPM. 2008;51(3):379-81.

Bandyopadhyay S, Thakur JS, Ray P, Kumar R. High prevalence of bacteriuria in pregnancy and its screening methods in North India. J Indian Med Assoc. 2005;103(5):9.

Koneman EW, Allen SD, Janda WM, Schrechenberger PC, Winn WC. Introduction to microbiology: Part II: guidelines for the collection, transport, processing, analysis and reporting of cultures from specific specimen sources. In: Koneman EW, Allen SD, Janda WM, Schrechenberger PC, Winn WC, eds. Color Atlas And Textbook Of Diagnostic Microbiology. 5th ed. Philadelphia: Lippincott. 1997:136-142.

Carman RH. Haematology. In: Carman RH, eds. Handbook of Medical Laboratory Technology. 2nd ed. New Delhi: Christian Medical Association of India. 2004:76-156.

Wayne PA. Performance standards for antimicrobial susceptibility testing. In: Wayne PA, eds. Clinical and Laboratory Standards Institute. Nineteenth informational supplement. USA: CLSI; 2009:M100-S19.

Kerure RD, Umashanker. Prevalence of asymptomatic bacteriuria among pregnant women in a tertiary care hospital. Int J Sci Res Publ. 2013;3(11):1-4.

Rouse DJ, Andrews WW, Goldenberg RL, Owen J. Screening and treatment of asymptomatic bacteriuria of pregnancy to prevent pyelonephritis: a cost-effectiveness and cost-beneficial analysis. Obstet Gynaecol. 1995;86:119-23.

Enayat K, Fariba F, Bahram N. Asymptomatic bacteriuria among pregnant women referred to outpatient clinics in Sanandaj, Iran. Int Braz J Urol. 2008;34(6):699-707.

Kerure SB, Surpur R, Sagarad SS, Hegadi S. Asymptomatic bacteriuria among pregnant women. Int J Reprod Contracept Obstet Gynaecol. 2013;2:213-6.

Neupane MS, Dhakal KS, Neupane HC, Adhikari S, Aryal B. Asymptomatic bacteriuria among pregnant women attending the outpatient clinic of Chitwan medical college teaching hospital, Chitwan, Nepal. Int Res J Pharm. 2012;3(11):78-80.

Jain V, Das V, Agarwal A, Pandey A. Asymptomatic bacteriuria and obstetric outcome following treatment in early versus late pregnancy in north Indian women. Indian J Med Res. 2013;137:753-8.

Jennifer P, Cyril R, Piyumi P, Nimesha G, Renuka J. Asymptomatic bacteriuria in pregnancy: prevalence, risk factors and causative organisms. Sri Lankan J Infect Dis. 2012;1(2):42-6.

Gayathree L, Shetty S, Deshpande SR, Venkatesha DT. Screening for asymptomatic bacteriuria in pregnancy: an evaluation of various screening tests at the Hassan district hospital, India. J Clin Diagn Res. 2010;4(4):2702-6.

Obirikorang C, Quaye L, Bio FY, Amidu N, Acheampong, Addo K. Asymptomatic bacteriuria among pregnant women attending ante-natal clinic at the university hospital, Kumasi, Ghana. J Med Biomed Sci. 2012;1(1):38-44.

Ajayi AB, Nwabuisi C, Aboyeji AP, Ajayi NS, Fowotade A, Fakeye OO. Asymptomatic bacteriuria in antenatal patients in Ilorin, Nigeria. Oman Med J. 2012;27(1):31-5.

Oli AN, Okafor CI, Ibezim EC, Akujiobi CN, Onwunzo MC. The Prevalence and bacteriology of asymptomatic bacteriuria among antenatal patients in Nnamdi Azikiwe University teaching hospital Nnewi; South Eastern Nigeria. Nigerian J Clin Practice. 2010;13(4):409-12.