Antimicrobial sensitivity pattern of urine isolates from asymptomatic bacteriuria during pregnancy

ABSTRACT

Screening women for asymptomatic bacteriuria [ASB] on the first antenatal visit is a part of standard obstetric care. Treating women with ASB decreases the chances of maternal and f0etal complications. This study was conducted to find out the spectrum of urine pathogens and their drug susceptibility pattern for ASB during pregnancy. The study was conducted in the Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre Karachi, from September 2001 to March 2002. Two hundred and ninety women, apparently normal with confirmed pregnancy, were registered. A voided midstream urine specimen was collected and cultured. A significant growth i.e. >/= 105 organisms/ml was identified with Analytical Profile Index 20 tests for identification of Enterobacteraceae [API-2o-E] and for Gram positive cocci by other standard methods. The prevalence of ASB was found 6.2%. Antimicrobial sensitivity was determined by disc diffusion Kirby Bauyer method after matching the turbidity with 0.5 McFarland's standard. Most of the recommended drugs were found to have encouraging results, however, Escherichia coli showed 66.67% resistance to ampicillins and sulphonamides. Enterobacters showed 100% resistance to ampicillins, cephalosporins and nitrofurantoin. Staphylococcus saprophyticus showed 66.67% resistance to ampicillins and sulphonamides. It was concluded that detection of ASB during pregnancy and appropriate use of antimicrobials is only possible after culture of urine. Empirical anti-microbial therapy cannot be relied upon because of possible risk of resistance