Bacterial etiologic agents, prevalence and associated risk factors of asymptomatic bacteriuria among pregnant and non-pregnant women in primary health care centers in South-South Nigeria
Nseobong Godwin Akpan, Anthony John Umoyen, Thomas Tentishe Luka, Idara Solomon Esua, Abraham Solomon Okon, Ukponobong Effiong Antia
Background: Asymptomatic Bacteriuria (ASB) has been demonstrated to have the adverse maternal and pregnancy outcomes like low birth weight, pyelonephritis, preterm labour and preterm premature rupture of membranes. Pregnant women are known to be more susceptible to ABS leading to UTIs if not treated properly. This study aimed to determine the prevalence, bacteriological agents, risk factors of ASB and antimicrobial sensitivity pattern among pregnant and non-pregnant women attending antenatal clinic in two primary health centers. Methodology: We conducted cross sectional study involving 246 pregnant women and 100 aged-matched non-pregnant women attending antenatal clinic at two primary health centers in Uyo and Osuk Ediene, South-south Nigeria. All women who met the inclusion criteria and gave their informed consent were invited to participate. Interviews using a questionnaire were conducted to collect socio-demographic data while urine samples were collected for laboratory processing. Clean catch mid-stream urine sample was collected and microbial analysis carried out immediately. Significant ASB was identified and antimicrobial sensitivity test conducted. Results: The prevalence of ASB among pregnant women in this study was 29.7%. Regarding their parity in the two PHC among pregnant women, 77(31.3%), 89(36.2%) and 80(32.5%) were nulliparous, monoparous and multiparous respectively. Also, 23(9.3%), 83(33.7%) and 140(56.9%) of the pregnant women were in the first, second and third trimester. One hundred and four (42.3%), 87(35.4%), 36(14.6%) and 19(7.7%) pregnant subjects were housewife, self-employed, employed and unemployed in their occupational status. Trimester was a factor for ASB in the second and third trimester. There was association between age, parity, trimester, education, occupation, numbers of partners and ASB; pointing them as risk factors. The microorganisms isolated from the urine sample according to the frequency of occurrence was Escherichia coli (28.7%), Staphylococcus aureus (20.5%), Klebsiellapneumoniae (19.2%), S. saprophyticus (11%), Pseudomonas aeruginosa (9.6%), etc. The rate of antibiotic sensitivity among gram negative bacteria ranged from 52% and above for all antibiotic tested with respect to Escherichia coli; except Azithromycine that was 14.3%. The Escherichia coli and other uropathogens isolates were multiple drug sensitive between 50-100%. Previous bacteriuria treatment seeking pattern in the pregnant women was 103(41.9%), 73(29.7%), 42(17.1%) and 8(3.3%) for individuals who had seek treatments in hospital, chemists, multi-centres and traditional herbs dealers respectively. Conclusion: The prevalence of ASB was 29.7% among pregnant women and the wide array of organisms isolated in this population using PHC warrant the development of protocols for routine ASB screening and proper treatment.