The enemy in shadows ‒ asymptomatic bacteriuria in pregnancy: a prospective, observational study

ABSTRACT

Background. One of the most prevalent infections encountered in clinical practice is urinary tract infection (UTI). Females are particularly vulnerable to UTI due to the short length of the urethra and proximity to the warm, wet anal canal and vagina. A urinary tract infection might be symptomatic or asymptomatic. Asymptomatic bacteriuria is defined as the presence of bacteria in significant numbers, i.e., 10⁵ bacteria per ml, within the urinary system despite the absence of evident symptoms. Because of the various morphological and physiological changes that occur during pregnancy, pregnant women are at a significant risk of having asymptomatic bacteriuria.
Materials and Methods. A prospective study was carried out among asymptomatic antenatal cases. Mid-stream clean catch urine sample was collected, semi-quantitative culture and antibiotic sensitivity was performed for the isolated organisms.
Results. Out of the 264 urine samples collected, 30 showed significant growth of organisms after overnight aerobic incubation at 37 ˚C (Asymptomatic Bacteriuria) with primigravida mothers at an increased risk. Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus and Staphylococcus saprophyticus were the common isolates. The gram-negative bacilli showed maximum resistance to Cefoperazone and least resistance to Nitrofurantoin. The gram-positive isolates were Cefoxitin resistant.
Conclusions. The Gold standard for detection of asymptomatic bacteriuria in antenatal mothers is urine culture at first prenatal visit or between 12 and 16 weeks of gestation. Without proper diagnosis and treatment, there is a high chance of developing symptomatic UTI, including pyelonephritis leading to preterm deliveries and perinatal complications.