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.

Childhood Septicaemia Due To Salmonella Species in Ibadan, Nigeria

A cross sectional study to assess the incidence and antibiotic sensitivity patterns of Salmonella isolates in septicaemic children who were presented at the children's emergency unit and children out-patient clinic, University College Hospital, Ibadan was undertaken. A total of 442 samples from children (6months and 11 years) with the history of fever were investigated, using blood culture method. The frequency of 151 bacteria isolated, were as follows: Staphylococcus aureus 50 (33.1%), Escherichia coli 29 (19.2%), Salmonella typhi 19 (12.6%), Staphylococcus albus 14(9.3%), Klebsiella species 12(7.9%), Pseudomonas aeruginosa 10(6.6%), Enterococcus faecalis 9(5.9%), Salmonella paratyphi 6(3.9%) and Haemophilus species 2(1.3%). Septicaemia due to Salmonella speciesshowed the highestamongchildren aged5-11years bracket (56%), followed by 1-5 years group (36%); while those within 0-1 year group showed the lowest frequency of (8%). Inthe antibiotic sensitivity patterns of Salmonella typhi and Salmonella paratyphi, only Ceftriaxone showed 100% sensitivity in-vitro.While Gentamicin, Ofloxacin,Cefrazidime; Augmentin, Pefloxacin, Chloramphenicol, Amoxycillin, Cotrimoxazole showed varied sensitivity/resistance in descending order. These findings suggest an increasing resistance to the antibiotics commonly used for salmonellosis and the rate at which bacteria become resistant to antimicrobial agents is of public health concern. This calls for routine bacteriological culture and sensitivity test in the management of bacterial infections. Furthermore, the provision of adequate health care, wholesome water for drinking and domestic use by governments cannot be overemphasized