ASYMPTOMATIC BACTERIURIA AMONG PREGNANT WOMEN ATTENDING ANTENATAL CLINIC AT FEDERAL MEDICAL CENTRE UMUAHIA (FMC)

ABSTRACT

From the study, Fifty (50) samples of urine were collected from pregnant women attending antenatal clinic at Federal Medical Centre Umuahia, with sterile bottles, to determine the asymptomatic bacteriuria among pregnant women population. Out of 50 samples tested, 20 (40%) were found to have asymptomatic bacteriuria while 30 (60%) had non bacteriuria. The frequency of isolation of organism was Staphylococcus aureus (8.4%), Escherichia coli (5.2.%), Klebsella (2.1%) and Pseudomonas aeruginosa (5.2%).Pregnant women in their third trimester had the highest with respect to age while trader had highest with respect to occupation. This study emphasizes the need for routine screening of the urine of pregnant women for asymptomatic bacteriuria.

TABLE OF CONTENTS

Cover page                                                                                                                              i

Title page                                                                                                                                ii

Certification                                                                                                                           iii

Dedication                                                                                                                              iv

Acknowledgement                                                                                                                  v

Abstract                                                                                                                                   vi

Table of contents                                                                                                                    viii

List of Tables                                                                                                                          x

List of Figure                                                                                                                          xi

CHAPTER ONE:  INTRODUCTION                                       1                                                                        

1.1    Aims and Objectives                                                                                                     2

CHAPTER TWO: LITERATURE REVIEW

2.1 Causes of asymptomatic bacteriuria in pregnant Women                                                            3

2.2       Consequences of Asymptomatic Bacteriuria                                                             4

2.3       Diagnosis of Asymptomatic Bacteriuria                                                                    4

2.4       Prevalence of asymptomatic Bacteriuria in Pregnant Women.                                    5

2.5       Prediposing Factors                                                                                                    6

2.6       Symptoms                                                                                                                   7

2.7       Complications of Asymptomatic Bacteriuria in Pregnant Women                                    7

2.8       Prognosis /Expectations                                                                                             8

2.9       Treatment of Asymptomatic Bacteriuria                                                                    8

CHAPTER THREE: MATERIALS AND METHODS

3.1      Study Area                                                                                                                   10

3.2       Study Population                                                                                                        10

3.3       Sample Collection                                                                                                      10

3.4       Media Preparation                                                                                                      10

3.5       Centrifugation                                                                                                            11

3.6       Microscopy                                                                                                                 11

3.7       Isolation                                                                                                                      11

3.8       Identification and Characterization of Isolates                                                                                                           11

3.8.1    Gram Staining                                                                                                            12

3.9       Biochemical Test                                                                                                        12

3.9.1   Antibiotic sensitivity testing                                                                                                                                                                14

 CHAPTER FOUR: RESULTS                                                                                           15

CHAPTER FIVE: DISCUSIONS, CONCLUSION AND RECOMMENDATION       23

5.1 Discussion                                                                                                                                                                                     23

5.2 Conclusion                                                                                                                                                                                    23

5.3 Recommendation                                                                                                                                                                          24

REFERENCES

APPENDIX

                                                          LIST OF TABLES

 Table

1      The prevalence of asymptomatic bacteriuria among pregnant women with their various age groups.         16                                                  

     2      Prevalence of asymptomatic bacteriuria among pregnant women according to their occupations.   17

     3      The prevalence of asymptomatic bacteriuria among pregnant women from Federal Medical Centre, Umuahia, Abia State according to their educational level.    18

     4     The prevalence of asymptomatic bacteriuria among pregnant women from Federal Medical Centre, Umuahia, Abia State according to their educational age of pregnancy.    19

     5     The prevalence of bacteria isolated from urine samples of pregnant women from Federal Medical Centre, Umuahia, Abia State.   20

     6      The antibiotic susceptibility of bacteria isolated from the urine samples of pregnant women from Federal Medical Centre, Umuahia, Abia State.    21                           

                                                         LIST OF FIGURE

Figure

1      Bar chart of  pregnant women that tested for average percentage susceptibility of the  isolates to the different antimicrobial agents.   22

LIST OF FIGURE

Figure 1: Bar chart of pregnant women that tested for average percentage susceptibility of the isolates to the different antimicrobial agents.                                                                                                                                                                    

CHAPTER ONE

1.0       INTRODUCTION

The physiological increase in plasma volume during pregnancy decreases urine concentration and up to 70% pregnant women develop glucosurea, which encourages bacterial growth in the urine. The adverse effects of undiagnosed asymptomatic bacteriuria on mother and child have made researchers to suggest routine culture screening for all pregnant women attending antenatal clinic in order to prevent mother and child from any form of complication that may arise due to infection. (Lucas et al., 1993).

Asymptomatic bacteriuria is the presence of bacteria in urine. It is a condition in which urine culture reveals a significant growth of pathogens that is greater than 105 bacteria/ml, but without the patient showing symptoms of urinary tract infection (UTI). This is common during pregnancy. Asymptomatic bacteriuria is caused by bacterial colonization of urinary tract. It affects about 5-10 percent of both sexually active and pregnant women (Dominic, 2012).

Women identified with asymptomatic bacteriuria in early pregnancy have 20-30 fold increased risk of developing pyelonephritis during pregnancy, compared with women without bacteriuria. These women also are more likely to experience premature delivery and to have infants of low birth weight. (Akerele et al., 2001).

Urinary Tract Infection (UTI) refers to both microbial colonization of the urine and tissue invasion of any structure of the urinary tract. Bacteria are most commonly responsible, although

yeast and viruses may also be involved.  Asymptomatic bacteriuria, in which urine culture reveals a significant growth of pathogens. Asymptomatic bacteriuria can be found in both pregnant and non pregnant women. Pregnancy enhances the progression from asymptomatic to symptomatic bacteriuria which could lead to pyelonephritis and adverse obstetric outcomes such as prematurity, low- birth weight, and higher foetal mortality rates. Although some studies have postulated that since asymptomatic bacteriuria, usually caused by aerobic gram-negative bacilli or Staphylococcus haemolyticus can lead to UTI, pregnant women should be screened for bacteriuria by urine culture at least once in early pregnancy and they should be treated if the results are positive (Akerele et al., 2001, Dominic, 2012).

1.1    Aims and Objectives   

  This study is therefore aimed to determine the asymptomatic bacteriuria in pregnant women attending Federal Medidical Centre Umuahia and also to determine the antimicrobial susceptibility pattern of the isolates.

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