Asymptomatic bacteriuria in pregnancy in Port Harcourt

ObjectiveTo determine the prevalence of asymptomatic bacteriuria in pregnancy, to consider the antimicrobial sensitivity patterns of involved uropathogens, to elucidate the safety profiles of antibacterial agents, and to evaluate the role of urinalysis in screening for asymptomatic bacteriuria.MethodsAbout 760 apparently healthy pregnant subjects attending the Antenatal Clinic of the University of Port Harcourt Teaching Hospital were randomly selected for this study. Urinalysis and microscopy, culture, and sensitivity tests were carried out on clean-catch midstream urine samples obtained from subjects. Biochemical reagent strips were used for urinalysis while the standard wire loop and agar diffusion technique were respectively employed for culture and susceptibility testing.ResultsA total of 111 samples yielded moderate or severe growth on culture after 48 hours comprising 35, 31, 27, and 18 isolates of Staphylococcus spp., Proteus spp., Klebsiella spp., and Escherichia spp, respectivehy. Urinalysis results were positive for the presence of nitrate reductase and leucocyte esterase activity in 17 urine samples of these 111 samples. The isolates showed a general sensitivity to the fluorinated quinolones and to Nitrofurantoin.ConclusionsThe prevalence of asymptomatic bacteriuria is 14.6%, with the predominant organism being Staphylococcus spp. Drugs used for treatment should have excellent fetal safety profiles, and a rapid screening test with a high negative predictive value for asymptomatic bacteriuria would be ideal.