Asymptomatic Uropathogenic Bacteriuria Among Pregnant and Non-pregnant Women at St Luke’s Hospital Anua, Offot Ukwa District Uyo: A Reassessment Case-Control Approach
American Journal of Laboratory Medicine
Volume 4, Issue 1, January 2019, Pages: 1-10
Received: Jan. 16, 2019;
Accepted: Feb. 19, 2019;
Published: Mar. 18, 2019
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Nseobong Godwin Akpan, Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, University of Uyo, Uyo, Nigeria; Medical Microbiology Unit, Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Nigeria
Anthony John Umoyen, Department of Genetics and Biotechnology, Faculty of Biological Sciences, University of Calabar, Calabar, Nigeria
Thomas Tentishe Luka, Department of Biological Sciences, Taraba State University, Jalingo, Nigeria
Ifeanyi Abraham Onwuezobe, Department of Medical Microbiology and Parasitology, Faculty of Clinical Sciences, University of Uyo Teaching Hospital, Uyo, Nigeria
Ukponobong Effiong Antia, Department of Biological Sciences, Akwa Ibom State University, Mkpat Enin, Nigeria
Abraham Solomon Okon, Department of Genetics and Biotechnology, Faculty of Biological Sciences, University of Calabar, Calabar, Nigeria
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 1st, 2nd and 3rd 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 Escherichia coli (28.4%), followed by Klebsiella pneumonia (23.9%). The Escherichia coli 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.
Nseobong Godwin Akpan,
Anthony John Umoyen,
Thomas Tentishe Luka,
Ifeanyi Abraham Onwuezobe,
Ukponobong Effiong Antia,
Abraham Solomon Okon,
Asymptomatic Uropathogenic Bacteriuria Among Pregnant and Non-pregnant Women at St Luke’s Hospital Anua, Offot Ukwa District Uyo: A Reassessment Case-Control Approach, American Journal of Laboratory Medicine.
Vol. 4, No. 1,
2019, pp. 1-10.
Oladeinde B. H Omoregie R, Oladeinde O. B. (2015). Asymptomatic urinary tract infection among pregnant women receiving ante-natal care in a traditional birth home in Benin City, Nigeria. Ethiop Journal of Health Science 25(1): 3-8.
Abdullah A. A, Al-Moslih, M. I. (2005). Prevalence asymptomatic bacteriuria in pregnant women in Sharjah, United Arab Emirates. East Mediterr Health Journal 11: 5-6.
Feitosa D. C. A, Silva M. G, Parada C. M. G. L (2009). Accuracy of simple urine tests for diagnosis of urinary tract infections in low-risk pregnant women. Rev Latino-Am Enfermagem 17(4): 507-513.
Akpan N. G, Onwuezobe I. A, Antia U. E. (2017). Asymptomatic bacteriuria among pregnant women at University Hospital in Uyo, Nigeria: Prevalence risk factors and characteristics. Asian Journal of Medicine and Health 3(3):1-9.
Duarte G, Marcolin A. C, Quintana S. M., Cavalli, R. C. (2008). Urinary tract infection in pregnancy. Rev Bras Gynecology Obstect. 30: 93-100.
Alemu A, Moges F, Shiferaw Y, Tafess K, Kassu A, Anagaw B, Agegn A. (2012). BMC Research Notes 5(197): 1-7.
Chaliha C, Stanton S. L. (2002). Urological problems in pregnancy. British Journal of Urology International 89: 469-476.
Glaser AP, Schaeffer A. J. (2015). Infection and bacteriuria in pregnancy. Urol Clin North America 42 (4): 547-560.
Small F, Vazquez J. C. (2007). Antibiotics for asymptomatic bacteriuria in pregnancy. Cochane Database of Systematic Reviews 2.
Schnarr J, Small F. (2008). Asymptomatic bacteriuria and symptomatic urinary tract infections in pregnancy. Eur Journal of Clin Invest. 38(2): 50-57.
Ade-Ojo IP, Oluyege A. O, Adegun PT, Akintayo AA, Aduloju OP, Olofinbiyi BA (2013). Prevalence and antimicrobial susceptibility of asymptomatic significant bacteriuria among new antenatal enrollees in south west Nigeria International Research Journal of Microbiology 4(8): 197-203.
Tadesse E, Teshome M, Merid Y, Kibret B, Shimelis T. (2014). Asymptomatic urinary tract infection among pregnant women attending the antenatal clinic of Haussa referral hospital, Southern Ethiopia. BioMed Cental Res Note 7(155) :1-5.
Alfred A. O, Chiedozie I, Martin D. U. (2013). Pattern of asymptomatic bacteriuria among pregnant women attending antenatal clinic at a private health facility in Benin, South Nigeria. Ann Afr Med. 12(3):160-164.
Beyene G, TsegayeW. (2011). Bacterial uropathogens in UTI and antibiotic susceptibility pattern in Jimma University specialized hospital. Ethiopia Journal of Health Sci. 21(2):141-146.
Ezechi O. C , Gab-Okafor C. V, Oladele DA, Kalejaiye O. O, Oke B. O, Ekama S. O, Audu RA, Okoye RN, Ujab I. A. (2013). Prevalence and risk factors of asymptomatic bacteriuria among pregnant Nigerians infected with HIV. Journal of Matern Fetal Neonatal Med. 26(4):402-406.
Gessese Y. A, Damessa D. L, Amare M. M, Bahta Y. H, Shifera A. D, Tasent F. S, Gebremedhin E. Z (2017). 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 Contro 16 (132): 1-10.
Fatima N, Ishrat S. (2006). Frequency and risk factors of asymptomatic bacteriuria during pregnancy. Journal of Coll Physicians Surg Park. 16: 273-275.
Gabre-Selassie S. (1998). Asymptomatic bacteriuria in pregnancy: Epidemiological clinical and microbilogical approach. Ethiop Med Journal 36: 185-192.
Assefa A, Asrat D, Woldeamanuel Y, G/Hiwot Y, Abdella A, Melesse T. (2008). Bacterial profile and drug susceptibility pattern of urinary tract infection in pregnant women at Tikur Anbessa Specialist Hospital, Addis Ababa, Ethiopia. Ethiopia Medical Journal. 46: 227-235.
Jennifer P, Cyril R, Piyumi P, Nimesha G, Renuka J. (2012). Asymptomatic bacteriuria in pregnancy; Prevalence, risk factors and causative organism. Sri Lanka Journal of Infectious Diseases 1(2): 42-46.
Oli A. N, Okafor C. I, Ibezim E. C, Akujiobi C. N, Onwunzo M. C (2010). The prevalence and bacteriology of asymptomatic bacteriuria among antenatal patients In Nnamdi Azikiwe University Teaching Hospital, Nnewi, South eastern Nigeria. Nigeria Journal of Clinic Practice 13(4): 409-412.
Onwuezobe A. I, Orok F. E. (2015). Extended spectrum beta-lactamase producing uropathogens in asymptomatic pregnant women attending antenatal care in an urban community secondary health facility. African Journal of Clinical and Experimental Microbiology 16(1): 49-53.
Karlowsky J. A, Hoban D. J, Decorby M. R, Laing N. M, Zhanel G. G (2012). Fluoroquinolone-resistance urinary isolates of Escherichia coli from outpatients are frequently multidrug; Results from the North American Urinary tract infection collaborative alliance-quinolone resistance study. Antimicrobial Agent and Chemotherapy 50: 2251-2254.
Solberg O. O, Ajiboye R, Riley L. W (2006). Origin of class 1a integron and genecassettes in a population-based sample of uropathogenic Escherichia coli. Journal of Clinical Microbiology 44: 1347-1357.
Agency of Clinical Innovation (ACT) Urology Network (2012). Collection of urine. Data accessed 2018. Available:http://www.aci.health.nsw.gov.au/data/assets/pdfile/005/165920/collection_of_urine_midstream_toolikit.pdf.
Ogunlesi T. A, Dedeke I. O. F., Kuponiyi O. T (2008). Socioeconomic classification of children attending specialist paediatric centres in Ogun State, Nigeria. Nigerian Medical Practitioner 54: 21-25.
Cheesbrough M (2000). District laboratory practice in tropical countries, part 2. Cambridge University Press, UK, 69-90.
Hoberman A, Wald E. R, Reynolds E. A, Penchansky L, Charron M. (1994). Pyuria and bacterieuria in urine specimens obtained by catheter from young children with fever. Journal of Pediatrics 124: 513-519.
Graham J. C, Galloway A. (2001). The laboratory diagnosis of urinary tract infection: Clinical microbiology laboratory, Royal Victoria infirmary Queen Victoria Road, New Castle; Upon Tyne UK, 54: 911-9.
Bryan C (2011). Infectious disease, urinary infections from infectious disease section of microbiology and immunology on-line. University of South Carolina. Data accessed: 21st August, 2018. Available: http://pathmicro.med.se.edu/infectious%infectioushtm.
World Health Organization (2003). Manual for the laboratory identification and antibiotic susceptibility testing of bacteria pathogens of public health importance in the developing world. Geneva.
National committee for Clinical Laboratory Standards (Clinical Laboratory Standard Institutes) (2012). Performance of standard for antimicrobial disk susceptibility test: Approved standards. M2-A7. PA USA: NCCL, 32 (1), Villanova.
Awonuga D. O, Dada-Adegbola H. O, Fawole A. O, Olala F. A, Onimisi-Smith H. O (2011). Asymptomatic bacteriuria among an obstetric population in Ibadan. West African Journal of Medicine 30 (20): 89-93.
Schneeberger C, Erwisch J. J. H. M, vanden Heuvel E. R, Mol B. W. J, Ott A, Geerlings S. E. (2018). Asymptomatic bacteruria and urinary tract infection In pregnant women with and without diabetes. Eur Journal of Obste tGynecol Reprod Biol. 222: 176-181.
Rahimkahni M, Khavari-Daneshvar H, Sharifian R. (2008). Asymptomatic bacteriuria and pyuria in pregnancy. Acta Med Iran 46(5): 409-412.
Kumar C. T, Carbnneau M, Keough A, Ma M, Tandon P (2013). Asymptomatic bacteriuria is an independent predictor of urinary tract infections in an ambulatory cirrhotic population: Prospective evaluation. Liver International 34(6).
Afunwa R. A, Odimegwu D. C, Iroha R. I, Esimone C. O. (2011). Antimicrobial resistance status and prevalence rate of extended spectrum beta-lactamase (ESBL) producers isolated from a mixed human population. Basic Medical Science 11(2): 91-96.
Olusanya O, Ogunledum A, Fakoya T. A. (1993). Asymptomatic significant bacteriuria among pregnant and non-pregnant women in and non pregnant women in Sagamus Nigeria. WAJM. 12(1): 27-33.
Imade P. E, Izekor P. E, Eghafona N. O, Enabulele O. I, Onyeagba O. I, Ophori E. (2010). Asymptomatic bactereriuria among pregnant women. North American Journal of Medical Science 2: 263-266.
Obiogbolu C. H, Okonko I. O, Anyamere C. O, Adedeji A. O. (2009). Incidence of urinary tract infection amongst pregnant women within Akwa Metropolis, South eastern Nigeria. Scientific Research and Essay 4:820-824.
Egbebi A. O Famurewa O. (2011). Prevalence of extended spectrum beta-lactamase (ESBL) Production among Klebsiella isolated in some part of south west Nigeria. Journal of Microbiology Biotechnology and Research 16(2): 64-68.
Amadi E. S, Enemuo O. B, Uneke C. J, Nwosu O. K, Onyeagba R. A, Ugbogu O. C. (2007). Asymptomatic bacteriuria among pregnant women in Abakaliki, Ebonyi State, Nigeria. Journal of Med Science 7(4): 698-700.
Kehinde A. O, Adedapo K. S, Aimaikhu C. O, Odukogbe A. A, Olayemi O, Salako B. (2011). Significant bacteriuria among asymptomatic antenatal clinic attendees in Ibadan. Nigeria Tropical Med and Health 39: 73-76.
Akinloye O, Ogbobu D. O, Akinloye O. M, Terry Alli O. A (2006). Asymptomatic bacteriuria of pregnancy in Ibadan, Nigeria: A reassessment. British Journal of Biomedical Science 63: 109-12.
Le J, Briggs G. G, McKeown A, Bustillo G. (2004). Urinary tract infections during pregnancy. Ann Pharmacotherapy 38(10): 1692-1701.
Moyo S. J, Aboud S, Kasubi M, Maselle S. Y. (2010). Bacterial isolates and drug susceptibility pattern of urinary tract infection among pregnant women at Mihimbili National Hospital in Tanzania. Tanzania Journal of Health Research 12(4): 233-236.
Kovavisarch E, Vichaipruck M, Kanjarahareutai S. (2009). Risk factors related to asymptmatic bacteriuria in pregnant women. Journal of Med AssocT hia. 9(5): 606-610.
Sheikh M. A, Khan M. S, Khatoon A, Arain G. M (2000). Incidence of urinary tract infection during pregnancy. East Mediterr. Health Journal 6(2-3): 265-271.
Hwang J. H, Park H. C, Jeong J. C, Baek B, Han M. Y, Bang K. (2013). Chronic asymptomatic pyuria proceeds overt urinary tract infection and deterioration of renal function in autosomal dominant polycystic kidney disease. BMC Nephrology 14.
Derese B, Kedir H, Teklemariam Z, Weldegebrea l. F, Balakrishnan S. (2016). Bacterial practice of UTI and antimicrobial susceptibility pattern among pregnant women attending at antenatal clinic in Dil Chora referral Hospital, Dire Dawa, Eastern Ethiopia. Ther. Clin. Risk Manag. 12(1): 251-260.
Sabrina J, Said A, Mabula K, Samuel Y (2010). Bacterial isolates and drug susceptibility patterns of urinary tract infection among pregnant women at Muhimbili National Hospital in Tanzania. Journal of Health Research 12: 4-14.
Amiri F. N, Rooshan M. H, Ahmady MH, Soliamani M. J. (2009). Hygiene practices and sexual activity associated with urinary tract infection in pregnant women. East Mediterr Health 15: 105-108.
Lavigne J. P, Boutet-Dubois A, Lqouini D, Combescure C, Bouziges N, Mares P, Sotto A. (2011). Virulence potential of E. coli strains causing asymptomatic bacteriuria during pregnancy. Journal Clin Microbiol. 49(1): 3950-3953.
Ramos NL, Sekikubo M, Dzung D. T, Kosnopfel C, Kironde F, Mirembe F, Brauner A. (2012). Uropathogenic E coli isolates from pregnant women in different countries. Journal of Clin Microbiol. 50(11): 3569-3574.
Mohammed M, Mahdy Z. A, Omar J, Maan N, Jamic MA (2002). Laboratory aspects of asymptomatic bacteriuria in pregnancy. Southeast Asian Journal Trop. Med. Public Health 33: 575-580.
Albrich W. C, Monnet D. L, Harbarth S. (2004). Antibiotics selection pressure and resistance in Streptococcus pneumonia pyogenes. Emerging Infectious Disease 38: 363-371.
Omoregie R, Eghafona N. O. (2009). Urinary tract infection among asymptomatic HIV patients in Benin City, Nigeria. British D. J Biomed Sci. 166(4): 190-193.