Bacterial Profile and ESBL Screening of Urinary Tract Infection Among Asymptomatic and Symptomatic Pregnant Women Attending Antenatal Care of Northeastern Ethiopia Region

Abstract

Background

Urinary tract infection is a common cause of morbidity in pregnant women. Emergence of antimicrobial resistance particularly ESBL production among bacterial uropathogens is increasing and becoming principal cause of treatment failure. The aim of this study was to determine the bacterial profile, their antimicrobial susceptibility patterns, risk factors and identify ESBL-producing bacterial uropathogens.

Patients and Methods

A hospital-based cross-sectional study was conducted in the Northeastern Ethiopia region. A total of 323 pregnant women were included and structured questionnaire was used to collect sociodemographic and risk factor-related data. About 10mL freshly voided midstream urine specimen was collected, transported and processed according to standard operating procedures. The data obtained were entered into SPSS version 22 and descriptive statistics, chi-square, bivariate and multivariate logistic regression analyses were performed. P-value ≤0.05 with corresponding 95% confidence interval were considered for statistical significance.

Results

The overall prevalence of UTI was 15.5% (50/323). The predominant bacterial isolates were Escherichia coli 17 (33.3%) followed by coagulase-negative staphylococci 15 (30.0%) and Staphylococcus aureus 14 (27.5%). Previous history of UTI (AOR=8.824, 95% CI: 3.769,20.654, P<0.001) and history of catheterization (AOR=3.270, 95% CI: 1.316,8.122, P=0.011) were significantly associated with the occurrence of bacterial UTI. Gram-negative isolates showed high level of resistance to ampicillin 12 (60.0%) and relatively low level of resistance to nitrofurantoin 5(25.0%), norfloxacin 5 (25.0%) and ceftazidime 3 (15.0%). Gram-positive uropathogens showed higher resistance for penicillin 29 (93.5%) and trimethoprim-sulfamethoxazole 23 (79.3%) whereas all isolates were sensitive 29 (100.0%) to nitrofurantoin. Moreover, multidrug resistance was observed among 41 (80.4%) of the isolates, and 3 (15.8%) of isolated gram-negative bacteria were ESBL producers.

Conclusion

High prevalence of bacterial UTI and MDR for commonly prescribed drugs were observed with significant number of ESBL producers. Therefore, instant UTI culture assessment of pregnant women, especially those having possible risk factors such as previous histories of UTI and catheterization; moreover, appropriate prescription and use of antibiotics are necessary.

Keywords:

• urinary tract infection
• pregnant women
• bacterial profile
• antimicrobial susceptibility pattern
• risk factors
• ESBL
• multidrug resistance

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Bacterial Profile and ESBL Screening of Urinary Tract Infection Among Asymptomatic and Symptomatic Pregnant Women Attending Antenatal Care of Northeastern Ethiopia Region [Corrigendum]

Acknowledgment

The author would like to acknowledge Mekelle University and Dessie Regional Health Research Laboratory for providing laboratory space and facilities to conduct the experiments. Dessie Referral Hospital and all study participants are acknowledged for their cooperation during sample collection.

Abbreviations

AOR, adjusted odds ratio; ASB, asymptomatic bacteriuria; ANC, antenatal care; ATCC, American Type Culture Collection; CI, confidence interval; CLED, Cystine Lactose Electrolyte Deficient medium; CLSI, Clinical and Laboratory Standards Institute; CoNS, coagulase-negative staphylococci; COR, crude odds ratio; DRH, Dessie Referral Hospital; ESBL, extended-spectrum beta-lactamase; MDR, multidrug resistance; MHA, Muller-Hilton Agar; SOPs, standard operating procedures; SPSS, Statistical Package for Social Sciences; SB, significant bacteriuria; UTI, urinary tract infection; WHO, World Health Organization.

Disclosure

The author reports no conflicts of interest in this work.