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      Bacterial Profile and Antibiotic Susceptibility Pattern of Urinary Tract Infection among Pregnant Women Attending Antenatal Care at a Tertiary Care Hospital in Southern Ethiopia

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          Abstract

          Background

          Urinary tract infection is one of the most common bacterial infections encountered in pregnant women with significant morbidity. This study aimed to determine the bacterial profile and its antimicrobial susceptibility pattern of urinary tract infection among pregnant women attending antenatal care (ANC) at a Hawassa University Comprehensive Specialized Hospital (HUCSH), Southern Ethiopia.

          Method

          A cross-sectional study was conducted in which consecutive pregnant women enrolled in the study from March to June 2019. The structured questionnaire used to collect sociodemographic and clinical data in a face-to-face interview. Midstream urine was collected from pregnant women using sterile containers. Culture and sensitivity were performed using a standard operating procedure of the microbiology laboratory. Data entry and analysis were conducted using the statistical package for social sciences (SPSS) version 20. Descriptive and logistic regression was used to conduct the output of the data. The odds ratio at 95% confidence interval was considered as a statistically significant association with a p value <0.05.

          Result

          The overall magnitude of urinary tract infection in this study was 7.8% (4.7–10.8%). Escherichia coli was found to be the most frequently isolated (47.8%), followed by Klebsiella pneumoniae (17.4%), Staphylococcus aureus (8.7%), Klebsiella ozaenae, Klebsiella rhinoscleromatis, Citrobacter spp., Salmonella group A, Staphylococcus saprophyticus, and Enterobacter cloacae each (4.3%). Gram-negative bacteria were sensitive to 78.3%, 91.3%, and 100% of ciprofloxacin, gentamicin, and nitrofurantoin, respectively. Gram-positive bacteria were sensitive to clindamycin (100%), gentamicin (100%), and nitrofurantoin (100%) and fully resistant to ceftriaxone (100%) and cefuroxime (100%). There is no statistically significant association ( p < 0.05) between the risk factor of urinary tract infection and UTI.

          Conclusion

          The overall prevalence of urinary tract infection among pregnant women attending antenatal care was 7.8%. Escherichia coli were the dominant isolate followed by Klebsiella pneumoniae. Gram-negative isolates are highly sensitive to ciprofloxacin, gentamicin, nitrofurantoin, and ceftriaxone and Gram-positive isolates to gentamicin, clindamycin, and nitrofurantoin. Most of the bacteria are resistant to cotrimoxazole and cefuroxime. There is no statistically significantly associated variable. Screening for the presence of urinary tract infection during pregnancy will improve the quality of antenatal care further reducing complication. The above antibiotics can be prescribed based on the side effect to pregnant women in case empirical treatment is mandatory in the study area.

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          Most cited references63

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          Antibiotic susceptibility testing by a standardized single disk method.

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            Urinary tract infections: disease panorama and challenges.

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              Asymptomatic bacteriuria and symptomatic urinary tract infections in pregnancy.

              Symptomatic and asymptomatic bacteriuria is common in pregnant women. A history of previous urinary tract infections and low socioeconomic status are risk factors for bacteriuria in pregnancy. Escherichia coli is the most common aetiologic agent in both symptomatic and asymptomatic infection and quantitative culture is the gold standard for diagnosis. Treatment of asymptomatic bacteriuria has been shown to reduce the rate of pyelonephritis in pregnancy and therefore screening for and treatment of asymptomatic bacteriuria has become a standard of obstetrical care. Antibiotic treatment of asymptomatic bacteriuria is associated with a decrease in the incidence of low birth weight, but the methodological quality of the studies limits the strength of the conclusions that can be drawn. Debate exists in the literature as to whether treated pyelonephritis is associated with adverse fetal outcomes. There is no clear consensus in the literature on antibiotic choice or duration of therapy for infection. With increasing antibiotic resistance, consideration of local resistance rates is necessary when choosing therapy.
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                Author and article information

                Contributors
                Journal
                Can J Infect Dis Med Microbiol
                Can J Infect Dis Med Microbiol
                CJIDMM
                The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien des Maladies Infectieuses et de la Microbiologie Médicale
                Hindawi
                1712-9532
                1918-1493
                2020
                24 December 2020
                : 2020
                : 5321276
                Affiliations
                1Hawassa University College of Computational and Natural Science Department of Biology, Awassa, Ethiopia
                2Hawassa University College of Medicine and Health Science School of Medical Laboratory, Awassa, Ethiopia
                Author notes

                Academic Editor: Pietro Mastroeni

                Author information
                https://orcid.org/0000-0001-7579-8991
                Article
                10.1155/2020/5321276
                7775162
                33425076
                04393a9e-8ad4-4a80-b2f6-6c8bdf3c414a
                Copyright © 2020 Ashenafi Tula et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 June 2020
                : 30 September 2020
                : 10 December 2020
                Categories
                Research Article

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