Bacteriuria among Pregnant Women Attended on Antenatal Care Clinics in Karu Local Government Area, Nasarawa State

Abstract

Aims: This study is aimed at studying the prevalence of bacteriuria among pregnant women attending antenatal care clinics in Karu Local Government Area of Nasarawa State, Nigeria. Study Design: A cross-sectional studies of the prevalence of bacteriuria among pregnant women at antenatal care clinics in Karu, Nasarawa State, Nigeria Place and Duration of Study: Antenatal care clinics in Karu Local Government Area of Nasarawa State were enrolled in the study which lasted for four months between October 2017 to January 2018. Methodology: Four hundred and fifty (450) midstream urine specimens were collected in sterile disposable urine containers and transported to microbiology laboratory of Bingham university for analysis. A structured questionnaire was administered to all participant whose informed consent was sort and samples collected. Samples collected were analysed using microscopy, morphological characteristics of inoculum on Maconkay, blood agar and cystine lactose electrolyte deficient agar (CLED) and biochemical characteristics of the grown colony. Antimicrobial Susceptibility Testing: From a pure culture of an identified bacterium, a loopful bacterial colony were transferred to a tube containing 5 ml of normal saline and mixed gently until it formed a homogenous suspension. The turbidity of the suspension was then adjusted to the density of mcfarland 0.5 to standardize the inoculum size. A sterile cotton swab was then dipped into the suspension and the excess was removed by gentle rotation of the swab against the surface of the tube. The swab was then used to distribute the bacteria evenly over the entire surface of Mueller-Hinton agar (oxoid). The inoculated plates were left at room temperature to dry for 3-5 minutes. Thereafter sterile needles were used to aseptically place an antibiotic disc on the surface of the inoculated plate. 30 ug sumetrolin (SXT), 30 ug chloramphenicol (CH), 10 ug sparfloxacin (SP), 10 ug ciprofloxacin (CPX), 30 ug amoxicillin (AM), 30 ug augmentin (AU), 10 ug gentamicin (CN), 30 ug pefloxacin (PEF), 10 ug ofloxacin (OFX) and 30 ug streptomycin (S) were used for gram-negative bacteria isolates while 10 ug pefloxacin (PEF), 10 ug gentamicin (CN), 30 ug ampicillin-oxacillin (APX), 20 ug cefuroxine (Z), 30 ug amoxicillin (AM), 25 ug ceftriaxone (R), 10 ug ciprofloxacin, 30 ug streptomycin (S), 30 ug sumetrolin (SXT) and 10 ug of erythromycin (E) were used for gram-positive bacteria isolates. The plates were then incubated at 37ºC for 24 hours. diameters of the zone of inhibition around the discs were measured and the isolates were classified as sensitive, intermediate and resistant according to the standardized table supplied by CLSI (2014). Results: The results obtained showed that 285 (63.33%) of the pregnant women had bacteriuria. Out of this, there were 77.93% cases of asymptomatic and 22.03% symptomatic bacteriuria respectively. The bacteria isolated were Escherichia coli (25.42%), coagulase-negative Staphylococcus (20.34%), Klebsiella spp (13.56%), Streptococcus spp (16.94%.), Staphylococcus aureus (10.17%), P. aeruginosa (8.47%) and Proteus mirabilis (5.08%). Gram-negativee bacteria isolated were most susceptible to 25 ug of Augmentin with susceptibility rate of 77.4% followed by 10 ug of gentamicin with 70.9% and 10 ug of Pefloxacin with 61.3% while Gram-positive isolates were most susceptible to 20 ug of Cefuroxine with 60.7% susceptibility rate followed closely by 57.1% susceptibility to both 10 ug Gentamicin and 30 ug Amoxicillin and 53.6% to 10 ug of Erythromycin. The age bracket 26-35 years had the highest prevalence of bacteriuria, (83.3%). women in their third trimesters were most infected with the prevalence rate of 91.39%. statistical analysis revealed significant differences (p<0.05) between bacteriuria and age, gestational age and occupation. Conclusion: This study recorded a significantly high prevalence of bacteriuria in the study area among the participant. This high prevalence calls for concern due to the possible effect of bacteriuria on the fetus. also having a significant percentage of this prevalence being asymptomatic (i.e 77.93%), there is, therefore, need to educate the women on personal hygiene and also need for treatment. also noting the increasing rate of resistance to the commonly administered antibiotics, thus the need to embark on massive enlightenment campaign with prevention-focused messages. also, the treatment of asymptomatic bacteriuria among pregnant women needs to be made a priority to prevent birth complications.