A Study Of Asymptomatic Bacteriuria In Pregnancy In Ile - Ife, Southwestern Nigeria

Abstract

Asymptomatic bacteriuria presents a considerable risk to the mother and may lead to onset of acute pyelonephritis in about 5% of pregnant women and also increase the risk of fetal mortality. Apart from one previous study, no other study has been carried out in this environment hence our study. The objectives are to determine the prevalence of asymptomatic bacteriuria amongst pregnant women in the three trimesters of pregnancy, to isolate and characterize the bacteria agents involved in this condition and recommend methods of reducing incidence and possible attendant sequalae. A descriptive study with purposive sampling carried out at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife Southwestern Nigeria between May 2000 and April 2001 examined two hundred and one consecutive pregnant women attending the antenatal clinic. This included women in the three trimesters of pregnancy. Those with urinary tract infections were excluded. Each subject was given a sterile universal bottle and requested to collect midstream urine. Each sample was plated onto Cystein-Lactose-Electrolyte-Deficient (CLED) medium and chocolate agar (CA). The major bacterial colonies were isolated and characterized employing standard bacteriologic methods. The prevalence rate was 26%. Staphylococcus aureus was predominant (43.8%), of which 68.8% were beta-lactamase producers. Forty six point six percent of total isolates were Gram-negative rods; Klebsiella pneumoniae (6.8%), Escherichia coli (4.5%), Citrobacter freundii (4.5%) and others. The study recorded a relatively high prevalence of asymptomatic bacteriuria. While the bacterial isolates were multi-resistant to drugs traditionally employed to treat uropathogens, they were relatively sensitive to nitrofuratoin in vitro. Because of the high prevalence of asymptomatic bacteriuria, we recommend routine screening for this condition in all antenatal clinics in this environment to reduce the incidence and probable attendant sequalae.


Afr. J. Clin. Exper. Microbiol. 2004; 5 (3): 252-259