Bacterial profile of urinary tract infection and antimicrobial susceptibility pattern among pregnant women attending at Antenatal Clinic in Dil Chora Referral Hospital, Dire Dawa, Eastern Ethiopia

Figures & data

Table 1 Sociodemographic, obstetric, and clinical variables of pregnant women attending at Dil Chora Referral Hospital, Dire Dawa, Ethiopia

Characteristics	Total (n=186)
	Patient (n)	Percentage
Age
15–24	43	23.1
25–34	82	44.1
35–44	52	28
≥45	9	4.8
Residence
Rural	17	9.1
Urban	169	90.9
Educational status	13	7
Read and write	23	12.4
Primary (1–8)	43	23.1
High school (9–12)	75	40.3
Higher education (>12)	32	17.2
Marital status
Widowed	3	1.6
Married	171	91.9
Divorced	12	6.5
Monthly income (birr)
≤500	22	11.8
501–1,000	29	15.6
1,001–1,500	25	13.4
1,501–2,000	65	34.9
>2,000	45	24.2
History of UTI
Yes	50	26.9
No	136	73.1
History of catheter
Yes	2	1.1
No	184	98.9
History of antibiotics
Yes	54	29
No	132	71
Current symptoms
Yes	88	47.3
No	98	52.7
Parity
Nullipara	65	34.9
Primipara	42	22.6
Multipara	79	42.5
Gestational age
First trimester	54	29
Second trimester	50	26.9
Third trimester	82	44.1

Abbreviation: UTI, urinary tract infection.

Table 2 Frequency and types of bacterial species isolated from urine culture of symptomatic and asymptomatic pregnant women with UTI attending at Dil Chora Referral Hospital, Dire Dawa, Ethiopia (2015)

Bacterial isolates	Asymptomatic bacteriuria (n=98)	Symptomatic UTI (n=88)	Total (n=186)
E. coli	4 (15.4%)	5 (19.2%)	9 (34.6%)
CONS	2 (7.7%)	3 (11.5%)	5 (19.2%)
Proteus spp.	1 (3.8%)	1 (3.8%)	2 (7.7%)
Klebsiella spp.	1 (3.8%)	2 (7.7%)	3 (11.5%)
P. aeruginosa	2 (7.7%)	2 (7.7%)	4 (15.4%)
S. aureus	1 (3.8%)	1 (3.8%)	2 (7.7%)
Citrobacter sp.	0 (0)	1 (3.8%)	1 (3.9%)
Total	11 (42.3%)	15 (57.7%)	26 (100%)

Abbreviations: CONS, coagulase-negative staphylococci; E. coli, Escherichia coli; P. aeruginosa, Pseudomonas aeruginosa; S. aureus, Staphylococcus aureus; UTI, urinary tract infection.

Table 3 Bivariate and multivariate analysis for the assessment of factors associated with UTI among pregnant women attending at Dil Chora Referral Hospital, Dire Dawa, Ethiopia (2015)

Characteristics	Culture		Bivariate analysis		Multivariate analysis
	Significant bacteriuria; no (%)	No significant bacteriuria; no (%)	COR	95% CI	AOR	95% CI	P-value
Age
15–24	2 (7.7%)	41 (25.6%)	1	1	1	1
25–34	19 (73.1%)	63 (39.4%)	6.183	1.367–27.963	5.569	2.167–19.255	0.008*
35–44	4 (15.4%)	48 (30%)	1.708	0.298–9.809	1.544	0.337–7.239	0.292
≥45	1 (3.8%)	8 (5%)	2.562	0.207–31.758	3.741	0.326–25.358	0.182
Residence
Rural	2 (7.7%)	15 (9.4%)	1	1	N/A	N/A
Urban	24 (92.3%)	145 (90.6%)	0.806	0.173–3.748	N/A	N/A
Educational status
Illiterate	4 (15.4%)	9 (5.8%)	3.111	0.643–15.049	1.013	0.002–11.509	0.13
Read and write	10 (38.5%)	13 (8.1%)	5.385	1.420–20.423	2.069	1.008–9.187	0.020*
Primary (1–8)	5 (19.2%)	38 (23.8%)	0.921	0.227–3.744	0.15	0.01–3.502	0.238
High school (9–12)	3 (11.5%)	72 (45%)	0.292	0.061–1.387	0.023	0.051–1.648	0.75
Higher education (>12)	4 (15.4%)	28 (17.5%)	1	1	1	1
Marital status
Widowed	1 (3.8%)	2 (1.2%)	1	1	N/A	N/A
Married	24 (92.3%)	147 (91.9%)	0.327	0.028–3.742	N/A	N/A
Divorced	1 (3.8%)	11 (6.9%)	0.182	0.008–4.263	N/A	N/A
Monthly income (birr)
≤500	9 (34.6%)	13 (8.1%)	15.462	3.525–26.325	11.503	1.789–19.397	0.025*
501–1,000	13 (50.0%)	16 (10%)	17.75	4.322–29.573	15.454	3.948–26.414	0.009*
1,001–1,500	1 (3.9%)	24 (15%)	1.833	0.110–30.637	1.491	0.151–27.706	0.33
1,501–2,000	2 (7.6%)	63 (39.4%)	1.397	0.123–15.882	0.037	0.322–11.345	0.174
>2,000	1 (3.9%)	44 (27.55%)	1	1	1	1
History of UTI
No	5 (19.2%)	131 (81.9%)	1	1	1	1
Yes	21 (80.8%)	29 (18.1%)	18.972	6.606–54.488	10.793	2.008–50.027	0.006*
History of catheter
No	25 (96.2%)	159 (99.4%)	1		N/A	N/A
Yes	1 (3.8%)	1 (0.6%)	6.36	0.385–10.497	N/A	N/A
History of antibiotics
No	4 (15.4%)	128 (80%)	1	1	1	1
Yes	22 (84.6%)	32 (20%)	19	7.081–68.350	1.127	0.099–12.827	0.923
Current symptoms
No	11 (42.3%)	87 (54.4%)	1	1	N/A	N/A
Yes	15 (57.7%)	73 (45.6%)	1.625	0.703–3.757	N/A	N/A
Parity
Nullipara	1 (3.8%)	64 (40%)	1	1	1	1
Primipara	2 (7.7%)	40 (25%)	3.2	0.281–19.448	0.779	0.041–14.935	0.868
Multipara	17 (65.4%)	56 (35%)	16.286	3.439–20.941	5.735	0.502–16.560	0.16
Gestational age
First trimester	2 (7.7%)	52 (32.5%)	1	1	1	1
Second trimester	7 (26.9%)	43 (26.9%)	4.233	0.835–21.444	3.743	0.375–37.378	0.194
Third trimester	17 (65.4%)	65 (40.6%)	6.8	1.502–30.777	1.004	0.107–9.469	0.372

Note:

* Statistically significant at P≤0.05.

Abbreviations: AOR, adjusted odds ratio; COR, crude odds ratio; 1, reference group; 95% CI, 95% confidence interval; UTI, urinary tract infection; N/A, not applicable.

Table 4 Antimicrobial susceptibility pattern of Gram-negative bacteria isolated from urine culture of pregnant women attending at Dil Chora Referral Hospital, Dire Dawa, Ethiopia (2015)

Bacterial isolates	Total no (%)	S, I, R	Antimicrobial agents/no of bacterial isolates (%)
			AMP	CRO	C	CIP	GEN	NA	AMO	SXT	F	TTC
E. coli	9 (47.3)	S	0 (0)	9 (100)	7 (77.8)	8 (88.9)	9 (100)	3 (33.3)	2 (22.2)	8 (88.9)	5 (55.6)	3 (33.3)
		I	2 (22.2)	0 (0)	1 (11.1)	0 (0)	0 (0)	2 (22.2)	0 (0)	0 (0)	0 (0)	0 (0)
		R	7 (77.8)	0 (0)	1 (11.1)	1 (11.1)	0 (0)	4 (44.4)	7 (77.8)	1 (11.1)	4 (44.4)	6 (66.7)
Proteus spp.	2 (10.5)	S	0 (0)	2 (100)	1 (50)	2 (100)	2 (100)	1 (50)	0 (0)	1 (50)	1 (50)	0 (0)
		I	0 (0)	0 (0)	1 (50)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)
		R	2 (100)	0 (0)	0 (0)	0 (0)	0 (0)	1 (50)	2 (100)	1 (50)	1 (50)	2 (100)
P. aeruginosa	4 (21)	S	0 (0)	3 (75)	0 (0)	3 (75)	2 (50)	1 (25)	0 (0)	0 (0)	1 (25)	1 (25)
		I	0 (0)	0 (0)	1 (25)	0 (0)	0 (0)	0 (0)	2 (50)	0 (0)	0 (0)	0 (0)
		R	4 (100)	1 (25)	3 (75)	1 (25)	2 (50)	3 (75)	2 (50)	4 (100)	3 (75)	3 (75)
Klebsiella spp.	3 (15.9)	S	0 (0)	3 (100)	1 (33.3)	2 (66.7)	2 (66.7)	1 (33.3)	0 (0)	0 (0)	0 (0)	1 (33.3)
		I	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	1 (33.3)	0 (0)	1 (33.3)	0 (0)	0 (0)
		R	3 (100)	0 (0)	2 (66.7)	1 (33.3)	1 (33.3)	1 (33.3)	3 (100)	2 (66.7)	3 (100)	2 (66.7)
Citrobacter spp.	1 (5.3)	S	0 (0)	1 (100)	0 (0)	1 (100)	1 (100)	0 (0)	0 (0)	1 (100)	1 (100)	0 (0)
		I	0 (0)	0 (0)	1 (100)	0 (0)	0 (0)	0 (0)	1 (100)	0 (0)	0 (0)	0 (0)
		R	1 (100)	0 (0)	0 (0)	0 (0)	0 (0)	1 (100)	0 (0)	0 (0)	0 (0)	1 (100)
Total	19 (100)	S	0 (0)	18 (94.7)	9 (47.4)	16 (84.2)	17 (89.5)	6 (31.6)	2 (10.5)	10 (52.6)	8 (42.1)	5 (26.3)
		I	2 (10.5)	0 (0)	4 (21)	0 (0)	0 (0)	3 (15.8)	3 (15.8)	1 (5.2)	0 (0)	0 (0)
		R	17 (89.5)	1 (5.3)	6 (31.6)	3 (15.8)	2 (10.5)	10 (52.6)	14 (73.7)	8 (42.1)	11 (57.9)	14 (73.7)

Abbreviations: AMO, amoxicillin; AMP, ampicillin; C, chloramphenicol; CIP, ciprofloxacin; CRO, ceftriaxone; E. coli, Escherichia coli; F, nitrofurantoin; GEN, gentamicin; NA, nalidixic acid; P. aeruginosa, Pseudomonas aeruginosa; S, I, R, sensitive, intermediate, resistant; SXT, trimethoprim–sulfamethoxazole; TTC, tetracycline.

Table 5 Antimicrobial susceptibility pattern of Gram-positive bacteria isolated from urine culture of pregnant women attending at Dil Chora Referral Hospital, Dire Dawa, Ethiopia (2015)

Bacterial isolates	Total no (%)	S, I, R	Antimicrobial agents/no of bacterial isolates (%)
			AMP	CRO	C	CIP	GEN	ERY	AMO	SXT	F	TTC
CONS	5 (71.4)	S	1 (20)	4 (80)	3 (60)	4 (80)	5 (100)	5 (100)	3 (60)	1 (20)	4 (80)	2 (40)
		I	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	1 (20)
		R	4 (80)	1 (20)	2 (40)	1 (20)	0 (0)	0 (0)	2 (40)	4 (80)	1 (20)	2 (40)
S. aureus	2 (28.6)	S	0 (0)	1 (50)	1 (50)	1 (50)	2 (100)	1 (50)	1 (50)	1 (50)	1 (50)	0 (0)
		I	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)
		R	2 (100)	1 (50)	1 (50)	1 (50)	0 (0)	1 (50)	1 (50)	1 (50)	1 (50)	2 (100)
Total	7 (100)	S	1 (14.3)	5 (71.4)	4 (57.1)	5 (71.4)	7 (100)	6 (85.7)	4 (57.1)	2 (28.6)	5 (71.4)	2 (28.6)
		I	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	1 (14.3)
		R	6 (85.7)	2 (28.6)	3 (42.9)	2 (28.6)	0 (0)	1 (14.3)	3 (42.9)	5 (71.4)	2 (28.6)	4 (57.1)

Abbreviations: AMO, amoxicillin; AMP, ampicillin; C, chloramphenicol; CIP, ciprofloxacin; CONS, coagulase-negative staphylococci; CRO, ceftriaxone; ERY, erythromycin; F, nitrofurantoin; GEN, gentamicin; S, I, R, sensitive, intermediate, resistant; S. aureus, Staphylococcus aureus; SXT, trimethoprim–sulfamethoxazole; TTC, tetracycline.

Table 6 Multidrug resistance pattern of Gram-negative bacteria isolated from urine culture of pregnant women attending at Dil Chora Referral Hospital, Dire Dawa, Ethiopia (2015)

Combination of antibiotics	No of Gram-negative bacterial isolates (%)
	Total	E. coli	Klebsiella spp.	Proteus spp.	P. aeruginosa	Citrobacter spp.
AMP, TTC	1 (5.3)	1 (11.1)	–	–	–	–
AMP, NA	1 (5.3)	1 (11.1)	–	–	–	–
AMP, AMO, TTC	4 (21)	3 (33.4)	–	1 (50)	–	–
AMP, AMO, NA	1 (5.3)	1 (11.1)	–	–	–	–
AMP, AMO, C	1 (5.3)	1 (11.1)	–	–	–	–
AMP, NA, TTC	1 (5.3)	–	–	–	–	1 (100)
AMO, NA, TTC	1 (5.3)	1 (11.1)	–	–	–	–
AMP, C, SXT, TTC	1 (5.3)	–	–	–	1 (25)	–
AMO, NA, SXT, TTC, CIP	1 (5.3)	1 (11.1)	–	–	–	–
AMP, C, AMO, F, TTC	1 (5.3)	–	1 (33.3)	–	–	–
AMP, AMO, GEN, TTC, F	1 (5.3)	–	1 (33.3)	–	–	–
AMP, AMO, NA, SXT, TTC	1 (5.3)	–	–	1 (50)	–	–
AMP, C, NA, SXT, F	1 (5.3)	–	–	–	1 (25)	–
AMP, C, AMO, NA, F, CIP	1 (5.3)	–	1 (33.3)	–	–	–
AMP, AMO, C, GEN, NA, SXT, TTC, F	1 (5.3)				1 (25)
AMP, AMO, CRO, GEN, NA, SXT, TTC, F, CIP	1 (5.3)	–	–	–	1 (25)	–
Total	19 (100)	9 (100)	3 (100)	2 (100)	4 (100)	1 (100)

Abbreviations: AMO, amoxicillin; AMP, ampicillin; C, chloramphenicol; CIP, ciprofloxacin; CRO, ceftriaxone; E. coli, Escherichia coli; F, nitrofurantoin; GEN, gentamicin; NA, nalidixic acid; P. aeruginosa, Pseudomonas aeruginosa; SXT, trimethoprim–sulfamethoxazole; TTC, tetracycline.

Table 7 Multidrug resistance pattern of Gram-positive bacteria isolated from urine culture of pregnant women attending at Dil Chora Referral Hospital, Dire Dawa, Ethiopia (2015)

Combination of antibiotics	No of Gram-positive bacterial isolates (%)
	Total	S. aureus	CONS
AMP, SXT	1 (14.3)	–	1 (20)
AMP, SXT, TTC	1 (14.3)	–	1 (20)
AMP, C, AMO, TTC	1 (14.3)	–	1 (20)
AMP, CRO, AMO, SXT	1 (14.3)	–	1 (20)
C, SXT, F, CIP	1 (14.3)	–	1 (20)
AMP, AMO, ERY, TTC	1 (14.3)	1 (50)	–
AMP, CRO, C, SXT, TTC, F, CIP	1 (14.3)	1 (50)	–
Total	7 (100)	2 (100)	5 (100)

Abbreviations: AMO, amoxicillin; AMP, ampicillin; C, chloramphenicol; CIP, ciprofloxacin; CONS, coagulase-negative staphylococci; CRO, ceftriaxone; ERY, erythromycin; F, nitrofurantoin; GEN, gentamicin; S. aureus, Staphylococcus aureus; SXT, trimethoprim–sulfamethoxazole; TTC, tetracycline.