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.

Trends in bacterial pathogens of lower respiratory tract infections.

OBJECTIVES: This study was conducted to determine the bacterial aetiology of lower respiratory tract infections in this environment as well as update the clinicians in the various antimicrobial alternatives available in the treatment. METHODS: Between September 2002 and February 2005, 157 bacterial pathogens from 556 patients with lower respiratory tract infections were isolated from sputum specimens, and subjected to susceptibility testing, using standard bacteriologic techniques. RESULTS: Out of the 556 cases, only 150 (27%) had an established bacterial aetiology. One pathogen was demonstrated in 143 (95.3%) patients and seven (4.7%) had mixed infections. The most prevalent single pathogen was Klebsiella pneumoniae (38%) while the most prevalent bacterial combination was Klebsiella and Pseudomonas species (2%). Isolates of Klebsiella pneumoniae were susceptible to ciprofloxacin, gentamicin and ceftriaxone. CONCLUSIONS: Bacteriological diagnosis and antibiotic resistance surveillance are indispensable in the effective management of lower respiratory tract infections.