Prevalence of and factors associated with significant bacteriuria among pregnant women attending the antenatal clinic of Adeoyo Maternity Hospital, Yemetu, Ibadan, Nigeria

Background: Significant bacteriuria is commonly reported in pregnancy which greatly predisposes pregnant women to urinary tract infection (UTI), one of the commonest health challenges in pregnancy worldwide especially in developing countries such as Nigeria. The objectives of this study are to determine the prevalence of and factors associated with significant bacteriuria among pregnant women attending the antenatal clinic (ANC) of Adeoyo Maternity Hospital, Yemetu, Ibadan, Nigeria, as well as determine the bacterial aetiology and antimicrobial susceptibility patterns of the isolates. Methodology: This is a laboratory-based cross-sectional study of 206 pregnant women between the ages of 15 and 47 years attending the ANC of the hospital, selected by simple random sampling method. Demographic and clinical data were obtained from the subjects using a structured questionnaire. Clean-catch specimen of mid-stream voided urine was collected from each subject participant. Urine samples were processed for culture and isolation of significant bacterial pathogens using standard bacteriological methods, and isolates identified to species level by the combination of colony morphology, Gram reaction, conventional biochemical tests and Analytical Profile Index (API) 20E test kits. Antibiotic susceptibility testing of the isolates to selected antibiotics was performed using the disk diffusion method. Results: The prevalence of significant bacteriuria in the study population was 8.7% (18/206), with 27.8% (5/18) symptomatic and 72.2% (13/18) asymptomatic. All isolated bacteria were Gram-negative with the most frequent being Escherichia coli 9 (50.0%), followed by Klebsiella pneumoniae 6 (33.3%), Pseudomonas aeruginosa 1 (5.6%), Acinetobacter haemolyticus 1 (5.6%) and Enterobacter aerogenes 1 (5.6%). The isolates were most sensitive to gentamicin (100%) and nitrofurantoin (94.4%), while they demonstrated highest resistance to amoxicillin-clavulanic acid (33.3%). Significant bacteriuria was associated with pyuria (p=0.01) and past history of UTI (p=0.004). Conclusions: The high prevalence of asymptomatic significant bacteriuria in this study necessitates the need for screening and treatment of pregnant women for this entity to prevent the subsequent development of UTI that may have grave consequences on pregnancy outcome.

Biochemical and bacteriological profiles of asymptomatic bacteriuria among school children in Ago-Iwoye, Nigeria

Background: Asymptomatic bacteriuria (ASB) in children is a predisposing factor to symptomatic urinary tract infection (UTI) that may be complicated by blood stream infections if not appropriately treated with resultant mortality or morbidity. The objectives of this study are to determine the prevalence of ASB, and evaluate both biochemical and bacteriological characteristics of urine samples of primary school pupils in Ago-Iwoye, Ijebu North Local Government Area (LGA), Ogun State, Nigeria. Methodology: Three hundred and seventy-two (186 males and 186 females) apparently healthy (asymptomatic) pupils aged 2-16 years from four randomly selected primary schools in the LGA were screened for ASB. Clean catch specimen of midstream urine was collected from each subject. Biochemical analysis of the urine was performed with Combi 10 reagent strip. MacConkey and Cysteine Lactose Electrolyte Deficient (CLED) agar plates were inoculated with calibrated wireloop delivering 0.01 ml of urine for aerobic culture at 37oC for 24 hours. Identification of significant bacteria on culture plates was done using conventional biochemical tests. Results: The frequency of clear, slightly turbid and turbid urine were 31 (8.3%), 99 (26.6%) and 56 (15.1%) respectively. All analyzed urine samples were alkaline and negative for ketone, glucose and blood, but contained protein in 230 (61.8%), bilirubin in 184 (49.5%), nitrites in 64 (17.2%) and urobilinogen in 14 (3.7%) subjects. The prevalence of significant bacteriuria was 11.8% (44 of 372) with 7.0% in males and 16.7% in females (p = 0.0063). The frequency of bacteria isolated in descending order were Escherichia coli 61.4%, Staphylococcus saprophyticus 61.4%, Staphylococcus aureus 45.5%, Bacillus subtilis 45.5%, Enterococcus faecalis 43.2%, Enterobacter spp 36.4%, Serratia marscencen 31.8%, Klebsiella pneumoniae 22.7%, Proteus mirabilis 22.7% and Pseudomonas aeruginosa 20.5%. Conclusion: This result highlights the presence of significant bacteriuria among apparently healthy pupils in the study area, with higher prevalence in the female pupils. The apparent risk of developing symptomatic UTI with the attendant complications in these pupils should spur preventive education of parents/guardians and the general populace about this entity

Asymptomatic urinary tract infection by proteus mirabilis in rheumatoid arthritis patients

Background: Proteus mirabilis is thought to contribute inrheumatoid arthritis (RA) development in susceptible individuals through molecular mimicry mechanism. This study was detecting the prevalence of asymptomatic bacteriuria (ABU) caused by Proteus mirabilis in RA patients to shed light on its rule in RA pathogenesis.Methods: This work has been conducted in medical Microbiology and Immunology Department and Rheumatology and Rehabitilation Department, Faculty of Medicine, Zagazig University, during the period from May 2017 to May 2018 over a period of 12 months. This study is a case control included 70 RA patients (66 females and 4 males), with age ranged from 25 to 65 years, and 70 healthy controls (67 females and 3 males), with age ranged from 24 to 65 years. Two consecutive urine samples one week interval were collected from each participant for urine count and culture. Blood samples were collected from each participant for detection the level of IgG antibodies against both Proteus mirabilis and E. coli (the most frequent isolated organism from the RA urine) by homely prepared ELISA. Results: The ABU was detected in (40%) of RA patients and in (4.3%) of healthy controls. The most common isolated organisms were E. coli (50%) followed by Proteus mirabilis (25%). A significant difference between both studied groups regarding IgG antibodies levels against Proteus mirabilis was detected (P< 0.001). No significant difference was observed between both studied groups regarding IgG antibodies levels against E. coli (P= 0.902). Significant positive correlation was found between Proteus mirabilis IgG antibodies levels and the levels of ESR and CRP in RA patients. In conclusion: Proteus mirabilis seems to have a role in RA development

Extended spectrum beta-lactamase-producing bacteria among diabetic patients with asymptomatic bacteriuria in a secondary health facility in Edo State, Nigeria

Asymptomatic bacteriuria (ASB) can increase the risk for developing symptomatic urinary tract infection (UTI) and diabetes mellitus is one of the high risk medical condition for ASB. This study was carried out to determine the prevalence of extended spectrum beta-lactamase (ESBL)-producing bacteria in diabetic patients attending Central Hospital, Benin City. The descriptive cross-sectional study design was adopted for this study, while data was obtained with the use of a structured questionnaire administered on 695 consented diabetic patients. Statistical analysis was done using the statistical software INSTAT� (Graph Pad Software Inc., La Jolla, CA, USA). Mid-stream urine samples were aseptically collected from these patients, processed and analysed using standard techniques. Identification of bacterial isolates and antimicrobial susceptibility testing were carried out using standard microbiological techniques. ESBL-producers were detected using appropriate phenotypic method. A total of 253(36.4%) patients were culture positive with Escherichia coli being the most predominant organism (37.5%). Proteus mirabilis was the highest ESBL producer and was statistically significant (50.0%) (p=0.0095). Uncontrolled glycaemia was associated with ESBL-production among bacterial isolates (P=0.0129). Age, gender and source of clinical isolates did not significantly affect ESBL production by the isolated uropathogenic bacteria (P >0.05).The prevalence of ESBL-producing bacteria among diabetic patients having ASB was 36.8%. Adherence to proper and effective antimicrobial regimen and laboratory guidance in treatment of ASB among diabetic patients are recommended

Prevalence, aetiology and antibiotic sensitivity profile of asymptomatic bacteriuria isolates from pregnant women in selected antenatal clinic from Nairobi, Kenya

Introduction: Asymptomatic bacteriuria (ASB) is the presence of bacteria in urine without apparent symptoms of urinary tract infections. The importance of asymptomatic bacteriuria lies in the insight it provides into symptomatic infections. To determine prevalence, bacterial isolates and Antibiotic Sensitivity Profile of asymptomatic bacterial urinary tract infection in pregnant women in selected clinics in Nairobi.Methods: This was a cross-sectional study involving women attending antenatal clinic at selected clinics of Nairobi County. The women who met the inclusion criteria were included in the study. The midstream urine samples of these women were subjected to microscopy, culture and sensitivity.Results: A total of 1020 of women on their first antenatal clinic visit participated in the study; 219 of them had ASB, giving a prevalence of 21.5 % at 95% confidence level. Escherichia coli were the common organism isolated at 38.8%. The majority of the organisms were sensitive to imipenem and gentamycin.Conclusion: There is a high prevalence of ASB among pregnant women included in the study from the Nairobi county clinics. Therefore, routine ASB screening of pregnant women is recommended among the women attending antennal clinics in Nairobi county clinics

Bacteriuria among Adult Non-Pregnant Women Attending Mulago Hospital Assessment Centre in Uganda

Background: Urinary tract infections (UTIs) in women are a common problem in primary health care settings. Resistance of bacterial uropathogens to commonly used antibiotics is common in many places. Objectives: To determine the prevalence of UTI; associated uropathogens and their antimicrobial susceptibility. Methods: A cross section study carried out at Mulago hospital outpatients' department. Midstream urine samples (MSU) were collected from 399 women; who gave informed consent and fulfilled other study criteria. Quantitative culture method; identification of uropathogens and antibiotic susceptibility testing using the Kirby-Bauer disc diffusion technique were applied to the isolates. Results: Out of 399 MSU samples; 40 pure significant bacterial growths (105 colony forming units (cfu)/ml of urine) were isolated and these included Escherichia coli; 23 (57.5); Staphylococcus aureus; 9 (22.5); Enterococci spp; 6 (15) and Klebsiella pneumoniae; 2 (5.0). Overall; sensitivities were: nitrofurantoin (98.3); cefuroxime (89.3); and cotrimoxazole (20) by all uropathogens isolated. Conclusions: Culture positive UTI among adult non-pregnant women are a common problem; occurring in 10of the study population. Most bacterial uropathogens showed high sensitivity to nitrofurantoin but low sensitivity to SXT. Recommendations: Nitrofurantoin should be considered as drug of choice for empirical treatment of community acquired uncomplicated UTI in adult non-pregnant women

Effect of instructions about the method of urine collection and storage on the isolation rate of urinary bacteria in children

A study of 65 children (29males and 36females) and aged between four weeks and 15years with significant bacteriuria was undertaking over a six month period to determine the effects of instruction received about the methods of urine collection and storage on the prevalence of urinary tract infection. The commonest clinical presentation was fever (64.6). Only 22(35.4) of the patients had specific symptoms suggestive of urinary tract infections. The instructions about urine collection were given to 48(73.8) care givers. This instruction was given by the attending doctors (84). Despite the explanation; 15(23.1) of the patients collected the urine samples wrongly and 44(67.7) stored the samples for longer than one hour. Significant bacteriuria was more prevalent in 74.2of patients who submitted their urine samples more than one hour after collection. Communication skill is important and should be emphasized in the trainings of health workers in procedure on the patients

Prevalence and Risks of Asymptomatic Bacteriuria among HIV Positive Pregnant Women

The objective of the study was to determine whether the prevalence of asymptomatic bacteriuria (ASB) and subsequent complications are higher in HIV-positive than in HIV-negative pregnant women. A prospective controlled study of asymptomatic pregnant women was carried out. One hundred and twenty-five consecutive HIV-positive women and 247 HIV-negative controls were screened for asymptomatic bacteriuria. Treatment of positive cultures was by means of antibiotics as per protocol. Nine percent (n=11) of HIV-positive patients and 7.9 (n=19) of HIV-negative patients had positive urine cultures (p=0.68). Microorganisms were similar in both groups. The incidence of preterm labour was 6.7 in the HIV-positive cohort; versus 11.3 in HIV-negative control patients (p=0.17). The rate of prelabour rupture of membranes was significantly increased in HIV-positive patients compared to HIV-negative controls (17 HIV-positive versus 13 HIV-negative patients; 14.17 and 5.42; respectively; RR 2.615; 95 CI; 1.314-5.204). CD4+ cell count level

The Prevalence and Bacteriology of Asymptomatic Bacteriuria among Antenatal Patients in Nnamdi Azikiwe University Teaching Hospital Nnewi; South Eastern Nigeria

Urinary tract infection in pregnancy leads to poor pregnancy outcome. Diagnosis and treatment of asymptomatic bacteriuria markedly improves pregnancy outcome as well as reduce the incidence of acute pyelonephritis. To determine the prevalence and bacteriology of asymptomatic bacteriuria among Antenatal patients in our centre; and to know if routine screening will be justifiable. This was a prospective study carried out between April and August 2008. Sample size was statistically determined.Women who consented were interviewed and mid stream urine samples were collected and processed in the microbiology laboratory; using standard microbiological methods. Out of 357 women studied; 65(18.21) had significant bacteriuria. was the commonest isolate (25.6); while was the least frequent isolate (3.66). Women in third trimester had the highest prevalence (25.68) while those in the first trimester had the least (15.79).Women that had only primary education had the highest prevalence (27.50) while those that had tertiary education had the least prevalence (21.10). The prevalence of significant asymptomatic bacteriuria among the women studied was high. Screening of all the pregnant women and treatment will reduce the incidence and complications of overt urinary tract infection in pregnancy among these women

Predictors of Asymptomatic Bacteriuria among Obstetric Population in Ibadan

Asymptomatic bacteriuria in pregnancy is the major risk factor for symptomatic urinary tract infection during pregnancy. Screening and identification of bacteriuria during pregnancy have been recommended.The general objective of the study was to determine the pattern as well as possible predictors of asymptomatic bacteriuria at the University College Hospital; Ibadan. The study was a descriptive; cross sectional; exploratory survey of the pattern of asymptomatic bacteriuria among all consecutive patients presenting for the first antenatal visit at the University College Hospital; Ibadan during the study period. The prevalence of asymptomatic bacteriuria was 10.7. Although no statistically significant association was found; the prevalence was higher among women aged between 26 - 35 years (11.5) and those with only secondary education (14.6). Other demographic parameters characterized by high rates of bacteriuria were Christian women (12.7compared to 4.3among Muslims) and genotypes AS andAC (16.4and 16.7respectively). Low parity (para 1-2); 2 and 3 trimesters of pregnancy were the identified possible obstetric predictors of bacteriuria in pregnancy. Staphylococcus species constitute the predominant isolates in 3 trimester and among Muslim pregnant women. Since no statistically significant predictors for bacteriuria in pregnancy were found; routine screening of all our pregnant women for this condition in 2 trimester is recommended

Clinical Significance of Bacteriuria in Patients with Orthotopic Sigmoid Neobladder after Radical Cystectomy

Objectives: To evaluate the incidence and clinical significance of bacteriuria in patients who underwent sigmoid neobladder substitution after radical cystectomy. Patients and Methods: The study included 149 patients with invasive bladder carcinoma who underwent radical cystectomy and orthotopic sigmoid bladder substitution. Diagnosis of bacteriuria was made by freshly collected midstream urine culture at 3; 6 and 12 months postoperatively. Positive urinary culture was defined as 100 000 colony forming units (CFU)/ml. The data collected were evaluated in correlation to the clinical status of the patients. Results: Overall 466 urine samples from 149 patients were cultured during the follow-up period. Out of these 149 patients; 18 were lost to follow-up and 11 patients developed new stone formation in the neobladder with an incidence of bacteriuria of 91. These 29 patients were excluded from the study. Among the remaining 120 patients; positive urine culture with significant growth of uropathogens was seen in 64; 47and 33at 3; 6 and 12 months; respectively. Two thirds of patients with positive urine cultures were asymptomatic. The commonest uropathogen encountered was E Coli (72) followed by Klebsiella (12). Conclusion: Sigmoid neobladder substitution is associated with a high incidence of bacteriuria. Despite; the spontaneous clearance of bacteriuria over time without antimicrobial manipulation; antimicrobial therapy was needed in some patients; particularly those with a large post-void residual (PVR) urine volume; persistent urosepsis and stone formation in the neobladder

Asymptomatic bacteriuria in pregnant women attending Antenatal Clinic at Komfo Anokye Teaching Hospital; Kumasi; Ghana

Objective: Symptomatic bacteriuria is common in pregnant women and if untreated could lead to serious complications. Although asymptomatic bacteriuria could also lead to such complications; this fact is not so well known. This study was to determine the prevalence of asymptomatic bacteri-uria in pregnant women attending antenatal clinic at the Komfo Anokye Teaching Hospital (KATH) Kumasi.Design: A prospective study to screen antenatal attendants for asymptomatic bacteriuria.Setting: The study was undertaken at KATH.Participants: All pregnant women attending ante-natal clinic at KATH; Kumasi between February and April 2003 and who agreed to enter the study were clinically evaluated to exclude signs and symptoms of urinary tract infection (UTI).Methods: Samples of 10-15ml urine were exam-ined for pus cells; bacteria and parasitic ova. The samples were further cultured on cysteine lactose electrolyte deficient agar and colony counts yield-ing bacterial growth of 105/ml or more of pure isolates were deemed significant.Results: Of the 220 pregnant women; 16 had sig-nificant bacteriuria giving a prevalence rate of 7.3. The highest age-specific prevalence was found in the 35-39 year-olds (13) and the lowest in the 15-19 year-olds (0.0). There was no sig-nificant difference in prevalence with increasing parity. The dominant bacteria isolates were E. coli (37) and Staph aureus (31).Conclusion: The prevalence of asymptomatic bac-teriuria in pregnant women at KATH is 7.3. The predominant organisms are E.coli and Staph au-reus; and most isolates are sensitive to nitrofuran-toin; cefuroxime and gentamicin

Laboratory Survey of Significant Bacteriuria in a Family Practice Clinic - Is the Spectrum of Causative Agents Changing?

Urinary tract infection correlates with significant bacteriuria. Empiric and definitive therapy depends on the sensitivity pattern of the causative agents; so it is essential to keep abreast of changes in the causative organisms. This study was carried out to determine the causative agents of significant bacteriuria and their antibiotic sensitivity pattern. Mid stream urine specimens were collected from all patients attending the Family Medicine Clinic of the Lagos State University Teaching Hospital; Ikeja Lagos in July and August of 2005. The urine specimens were transported on ice to the Medical Microbiology and Parasitology Department of the College of Medicine; Idi-Araba. Significant bacteriuria was determined by the standard loop method. Culture was performed on MacConkey agar (oxoid) and blood agar base (Oxoid) and Isolates were identified by standard laboratory methods. Antibiotic sensitivity was by disc diffusion method. Four hundred and fifty urine specimens surveyed for bacteria were from 251 females (55.8) and 199 males (44.2) with age range 13 to 89 years. Ninety four patients (20.9) had significant bacteriuria and 14 were symptomatic; making the prevalence rate of symptomatic bacteriuria 3.1. Out of 91 patients who had been on antibiotics; a significantly higher proportion (52) had bacteriuria while only 13.4 of those who had not been on antibiotics had bacteriuria. Klebsiella and Enterobacter species were more commonly isolated than E. coli. Most of the isolates were resistant to cotrimoxazole (89); tetracycline (69.1) and amoxicillin (88.1) and amoxicillin (88.1). Sensitivity rates to the urinary antiseptics ranged from 54.2 to 55.9. Many of the bacteria were sensitive to ofloxacin (92.9)); ciprofloxacin (84.7); cefotaxime(72.9); ceftriaxone(86.4) and ceftazidime( 88.1). Sensitivity to the aminoglycosides ranged from 57.7 to 59.3

Contribution a l'etude des infections urinaires de l'adulte noir africain en milieu hospitalier a Abidjan

Nous avons realise une etude retrospective de 250 cas d'infections urinaires recenses sur une periode de 5 ans (1998 a 2003) en milieu hospitalier a Abidjan; dans le but de determiner le profil epidemiologique; clinique; biologique ; evolutif et therapeutique de l'adulte noir africain Ce sont des malades hospitalises en Option : Medecine interne ayant beneficie d'un ECBU realise au laboratoire central. Les donnees relatives a chaque patient ont ete collectees a l'aide d'une observation planifiee puis saisies et traitees sur le logiciel EPI-INFO version 6.04. L'analyse des resultats de ce travail nous ~mene aux observations suivantes: -une frequence hospitaliere de 3;42pour cent; -une surmorbidite feminine (84;4pour cent); -une symptomatologie urinaire a type de pyurie (34;8pour cent); pollakiurie (19;4pour cent) et brulure mictionnelle (14;4pour cent); -une bacteriurie asymptomatique (76;8pour cent); une cystite (8pour cent); une pyelonephrite (6pour cent); une prostatite (4;8pour cent) et un syndrome uretral (3;2pour cent) etaient les differentes formes cliniques passees en revue; -une etiologie representee par E.Coli (28pour cent); Klebsiella pneumonia (21;6pour cent) et Candida albicans (20pour cent); -une antibiotherapie basee preferentiellement sur les quinolones et les cephalosporines a cause de leur grande sensibilite