DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20211108

Uropathogens and antimicrobial susceptibility profiles of asymptomatic bacteriuria among pregnant women receiving antenatal care in traditional birth attendants homes in Ikono, Akwa- Ibom State, Nigeria

Anthony John Umoyen, Nseobong Godwin Akpan, Cecilia James Sunday, Blessing Bassey Ekpenyng

Abstract


Background: Asymptomatic bacteriuria (ASB) in pregnancy is associated with adverse maternal and obstetric outcomes if untreated. The aim of this study was to determine the prevalence and susceptibility profile of ASB among pregnant women attending antenatal clinics in traditional birth attendant homes in Ikono, Akwa-Ibom State.

Methods: The study was a cross sectional survey using 350 pregnant women with ASB. Mid-stream clean catch urine samples were collected from the women using sterile containers. The urine samples were cultured, bacterial colonies were identified and antibiotic sensitivity was done. Data was analyzed using SPSS version 20.0 and significant was set at ≤0.05.

Results: The overall prevalence was 33.4% using 350 asymptomatic pregnant women. The mean age was 26.21±3.6 years and aged 27-32 have the highest prevalence (13.4) of ASB. 55.1% attained primary school, while 33.4% had informal education, monoparous (54%), 3rd trimester was 44.6% with 15.8% positive cases. Multigravidae was 71.1% with 19.4% positive cases. There was significant association of age, education, parity, occupation, monthly income, etc with ASB. The most common isolates were Escherichia coli (29.9%), then Klebsiella pneumonia (19.7%). Pseudomonas aeruginosa was susceptible to gentamicin (92%), Ciprofloxacin (83%) imipenam (83%) and azetronam (75%), while Staphylococcus saprophyticus was susceptible to imipenam (90%), then gentamicin at 80%. Multi-drug resistant were widespread in most of the isolates.

Conclusions: Multi-drug resistant were observed in most of the isolates. Continuous and collaborative surveillance of ASB and antimicrobial resistance pattern are essential to reduce the consequence of asymptomatic bacteriuria in pregnant women.


Keywords


Asymptomatic bacteriuria, Prevalence, Susceptibility profile, Traditional birth attendants, Uropathogens

Full Text:

PDF

References


Kamgang FdPS, Maise HC, Moodley J. Pregnant women admitted with urinary tract infections to a public sector hospital in South Africa: Are there lessons to learn? South Afr J Infect Dis. 2016;31(3):79-83.

Beksac AT, Orgul G, Tanacan A, Uckan H, Sancak B, Portakal O, Beksac MS. Uropathogens and Gestational Outcomes of Urinary Tract Infections in Pregnancies that Necessitate Hospitalization. Current Urol. 2019;13:70-3.

Matuszkiewicz-Rowińska J, Małyszko J, Wieliczko M. Urinary tract infections in pregnancy: Old and new unresolved diagnostic and therapeutic problems. Arch Med Sci. 2015;11(1):67-77.

Sibi G, Kumari P, Kabungulundabungi N. Antibiotic sensitivity pattern from pregnant women with urinary tract infection in Bangalore, India. Asian Pac J Trop Med 2014; 7(Suppl 1):S116-S120.

Ade-Ojo IP, Oluyege AO, Adegun PT, Akintayo AA, Aduloju OP, Olofinbiyi BA. Prevalence and antimicrobial susceptibility of asymptomatic significant bacteriuria among new antenatal enrollees in south west Nigeria. International Research Journal of Microbiol. 2013;4(8):197-203.

Jennifer P, Cyril R, Piyumi P, Nimesha, G, Renuka J. Asymptomatic bacteriuria in pregnancy; Prevalence, risk factors and causative organism. Sri Lanka Journal of Infectious Diseases. 2012;1(2):42-6.

Tadesse E, Teshome M, Merid Y, Kibret B, Shimelis T. Asymptomatic urinary tract infection among pregnant women attending the antenatal clinic of Haussa referral hospital, Southern Ethiopia. BioMed Cental Res Note. 2014;7(155):1-5.

Assefa A, Asrat D, Woldeamanuel Y, G/Hiwot Y, Abdella A, Melesse T. Bacterial profile and drug susceptibility pattern of urinary tract infection in pregnant women at Tikur Anbessa Specialist Hospital, Addis Ababa, Ethiopia. Ethiopia Medical J. 2008;46:227-35.

Oladeinde BH, Omoregie R, Oladeinde OB. Asumptomatic urinary tract infection among pregnant women receiving ante-natal care in a traditional birth home in Benin City, Nigeria. Ethiop Journal of Health Sci. 2015;25(1):3-8.

Akpan NG, Onwuezobe IA, Antia UE. Asyptomatic bacteriuria among pregnant women at University Hospital in Uyo, Nigeria: Prevalence, risk factors and characteristics. Asian J Medic Health. 2017; 3(3):1-9.

Nyanzi S, Manneh H, Walraven G. Traditional Birth Attendants in Rural Gambia: Beyond Health to Social Cohesion. African Journal of Reproductive Health. 2007;11(1):43-56.

Gambia and UNICEF. Situation analysis of children and women in The Gambia. Banjul: UNICEF, 1997. WHO; UNFPA; UNICEF. Traditional Birth Attendants; WHO: Geneva, Switerland, 1992; Available online: https://apps.who.int/iris/handle/10665/38994.

Ogbo FA, Trinh FF, Ahmed KY, Senanayake Y, Rwabilimbo AG, Uwaibi NE, et al. Global Maternal and Child, Health Research Collaboration (GloMACH). Prevalence, Trends, and Drivers of the Utilization of Unskilled Birth Attendants during Democratic Governance in Nigeria from 1999 to 2018. Int. J. Environ. Res. Public Health, 2020;17: 372-498.

Ahmed OA, Odunukwe NN, Akinwale OP, et al. Knowledge and practices of traditional birth attendants in prenatal services in Lagos State, Nigeria. Afr J Med Sci. 2005; 34(1):55–58.

Tsui AO, Wasserheit JN, Haaga JG, eds. Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions. Washington DC: 1996.

Imogie OI. The practice of traditional birth attendants and women’s health in Nigeria. 25th Congress Medical Women’s International Association. 2000. Available from: http://www.regional.org.au/au/mwia/ papers/full/28_imogie.htm. Accessed January 16, 2012.

Idowu OA, Mafiana CF, Sotiloye D. Rhesus negative pregnant women in a traditional birth home in Abeokuta, Nigeria. Afr J Biotechnol. 2003; 2(8):241-3.

Renkert ND. Opportunities to improve maternal health literacy through antenatal education: an exploratory study. Health Promot Int. 2001;16(4):381-8.

Abdel-Aziem AA, Duria AR, Ameer OA, Ishag A. Awareness of danger signs and nutritional education among pregnant women in Kassala, Eastern Sudan. Sudanese J Public Health. 2010;5:179-81.

Sadoh AE, Ogungbe RO. Multiple fractures and latrogenic burns in a Newborn due to unskilled Delivery: A case Report. Afr J Reprod Health. 2008;12(3):197-206.

Babalola S, Fatusi A. Determinants of use of maternal health services in Nigeria-Looking beyond individual and household factors. BMC Preg Child Birth. 2009;9:43-5.

Ndidi EP, Osaremen IG. Reasons given by pregnant women for late initiation of antenatal care in the Niger Delta. Nigeria. Ghana Med J. 2010;44(2):47-51.

Nguefack CT, Ebongue CO, Chokotheu CN, Ewougo CE, Njamen TN, Mboudou E. Clinical presentation, risk factors and pathogens involved in bacteriuria of pregnant women attending antenatal clinic of 3 hospitals in a developing country: a cross sectional analytic study. BMC Pregnancy and Childbirth. 2019;19:143-9.

Ebuehi OM, Akintujoye IA. Perception and utilization of traditional birth attendants by pregnant women attending primary health care clinics in a rural Local Government Area in Ogun State, Nigeria. International J of Women’s Health. 2012;4:25-34.

Akpan NG, Umoyen AJ, Luka TT, Onwuezobe IA, Antia UE, Okon AS. Asyptomatic uropathogenic bacteriuria among pregnant women and non-pregnant women at St Luke,s hospital Anua, Offot Ukwa District Uyo: a reassessment case-control approach. American J Laboratory Medic. 2019; 4(1):1-10.

Akpan NG, Umoyen AJ, Luka TT, Esua IS, Okon AS Antia UE. Bacterial Etiologic agents, Prevalence and Associated Risk Factors of Asymptomatic Bacteriuria among Pregnant and Non-pregnant Women in Primary Health Care Centers in South-South Nigeria. International J. of Med and Health Res. 2019;5(6):66-76.

Kirkwood BP, Sterne JAC. Sample size Calculation. In: essential medical statistics (2nd Edition). Blackwell Science Limited, Massachusetts, United States of American. 2003:413-28.

Gessese YA, Damessa DL, Amare MM, Bahta YH, Shifera AD, Tasent FS, et al. Urinary pathogenic bacteria profile, antibiogram of isolates and associated risk factors among pregnant women in Ambo Town, Central Ethiopia: A cross-sectional study. Antimicrobial Resistance and Infection Control. 2017;16(132):1-10.

Imade PE, Izekor PE, Eghafona NO, Enabulele OI, Onyeagba OI, Ophori E. Asymptomatic bactereriuria among pregnant women. North American J Medic Sci. 2010;2:263-6.

Hoberman A, Wald ER, Reynolds EA, Penchansky L, Charron M. Pyuria and bacterieuria in urine specimens obtained by catheter from young children with fever. J Pediatr. 1994;24:513-9.

Sadhvi K, Kose V. Frequency of urinary tract infections among pregnant women receiving antenatal care in a tertiary care centre: hospital based cross-sectional study. Int J Reprod Contracept Obstet Gynecol. 2021;10(1):207-14.

National committee for Clinical Laboratory Standards (Clinical Laboratory Standard Institutes). Performance of standard for antimicrobial disk susceptibility test: Approved standards. M2 – A7. PA USA: NCCL Villanova, 2012; 32(1).

Asmat U, Mumtaz MZ, Malik M. Rising prevalence of multidrug-resistant uropathogenic bacteria from urinary tract infections in pregnant women. Journal of Taibah University Medical Sciences, 2020.

Edae M, Teklemariam Z, Weldegebreal F, Abate D. Asymptomatic Bacteriuria among Pregnant Women Attending Antenatal Care at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia: Magnitude, Associated Factors, and Antimicrobial Susceptibility Pattern. International J Microbiol, 2020;8:1-8.

Wabe YA, Reda DY, Abreham ET, Gobene DB, Ali M M. 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. Therapeutics and Clinic Risk Management. 2020;16:923-32.

Banda JM, Cletus D, Sheyin Z, Junaid SA, John B, Mohammed SSD, Damen JG. Prevalence of asymptomatic Bacteriuria among Pregnant Women Attending Antenatal Clinic at Plateau State Specialist Hospital, Jos, Nigeria. Arch Microbiol Immunol. 2020;4(3):121-30.

Mwei M. K, Mchome B, John B, Maro E. Asymptomatic bacteriuria among women attending antenatal clinic at Kilimanjaro Christian Medical Centre in Northern Tanzania. Clin. Pract, 2018; 15(6): 917-922.

Lee ACC, Mullany LC, Koffi AK, Rafiqullah I, Khanam R, Folger LV, et al. Urinary tract infections in pregnancy in a rural population of Bangladesh: population based prevalence, risk factors, etiology, and antibiotic resistance. BMC Pregnancy and Childbirth. 2020;20:1-11.

Nteziyaremye J, Iramiot SJ, Nekaka R, Musaba M. W, Wandabwa J, Kisegerwa E, et al. Asymptomatic bacteriuria among pregnant women attending antenatal care at Mbale Hospital, Eastern Uganda. Plos One. 2020;15(3):19-31.

Bhola P, Mvelase NR, Balakrishna Y, Mlisana KP, Swe-Han KS. Antimicrobial susceptibility patterns of uropathogens isolated from pregnant women in KwaZulu-Natal Province. 2011 – 2016. S Afr Med J, 2020;110(9):872-6.