RESUMO
BACKGROUND AND OBJECTIVES: Urinary tract infection (UTI) is the most common clinical finding during pregnancy, and if it is asymptomatic bacteriuria (ASB), it can progress to pyelonephritis, leading to further complications. The present study aims to know the prevalence of ASB in pregnant females and the antimicrobial resistance pattern in our hospital setup. MATERIALS AND METHODS: A total of 552 urine samples were collected from pregnant females (with no symptoms of UTI) both attending outpatient department and admitted in the wards of obstetrics and gynecology department. Urine culture was performed on blood agar, MacConkey agar, and UTI chromogenic agar. Antibiotic sensitivity test was done using Kirby-Bauer disc diffusion method, and the results were interpreted. RESULTS: The prevalence rate of ASB in pregnant females was 17.4%. It was common in the age group of 25-33 years (60.4%). The infection rate was higher in the second trimester (43.7%) compared to the third (29.2%) and first (27.1%) trimester. Multiparity (60.4%) was a common finding in ASB during pregnancy. There was a significant finding of previous history of UTI (22.9%) and anemia (58.3%) associated with ASB in pregnant females. Escherichia coli (39.2%) was the most common microorganism isolated followed by Staphylococcus aureus (34.3%), Enterococcus faecalis (14.7%), Klebsiella (4.9%), coagulase-negative Staphylococcus spp. (2.9%), and Citrobacter and Acinetobacter (1.9%). Most sensitive drugs to be given in ASB during pregnancy were nitrofurantoin and fosfomycin. CONCLUSION: It was emphasized that urine culture should be done in early antenatal visit as routine screening to identify ASB in pregnant females as it can prevent fetal and maternal complications.
RESUMO
Extended spectrum beta-lactamase (ESBL) producing strains pose greatest therapeutic challenge and have been reported as emerging pathogens causing nosocomial infection. The present study was undertaken to detect the ESBL producing Esch coli and Klebsiella pneumoniae strains, which were screened to detect ESBL production. A total number of 320 E. coli and Klebsiella pneumoniae strains were processed in the microbiology department. Antibiotic sensitivity test with ciprofloxacin, amikacin, cefotaxime, ceftazidime, imipenem, etc, was put by Kirby Bauer method. ESBL producing strains were detected by double disc synergy test (DDST) using cefotaxime (30 microg) and amoxicillin/clavulanic acid (20/10 microg) disc. ESBL production was confirmed by minimum inhibitory concentration (MIC) reduction test in presence of clavulanic acid and fractional inhibitory concentration (FIC) index. MIC of cefotaxime was done by broth dilution technique. One hundred and thirty-seven strains (42.8%) were ESBL positive; 41.3% E. coli and 44.7% Klebsiella pneumoniae were ESBL producers; One E. coli strain and 4 Klebsiella pneumoniae strains had MIC of cefotaxime 256 microg/ml. To conclude, DDST method for screening of ESBL producing strains is quite simple, cost effective and yet reliable test which can be adopted by any clinical microbiology laboratory.
