Bacterial profile and drug susceptibility pattern of urinary tract infection in pregnant women at Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia.
BACKGROUND
Urinary tract infection (UTI) is a common complication of pregnancy. It may be symptomatic or asymptomatic.


OBJECTIVE
The aim of this cross sectional study was to identify bacterial agents and their antibiotic susceptibility pattern isolated from pregnant women with UTI attending antenatal clinic of Tikur Anbessa Specialized Hospital (TASH).


METHODS
Four hundred and fourteen pregnant women with asymptomatic UTI (n = 369) and symptomatic UTI (n = 45) were investigated for urinary tract infection from January to March 2005.


RESULTS
The age range of both groups was 18 to 44 years. Bacteriological screening of mid-stream urine specimens revealed that 39/369 (10.6%) and 9/45 (20%) had significant bacteriuria in asymptomatic and symptomatic group, respectively (p = 0.10). The overall prevalence of urinary tract infection was 48/414 (11.6%). The bacterial pathogens isolated were predominantly E. coil (44%), followed by S. aureus (20%), coagulase-negative staphylococci (16%), and K. pneumoniae (8%). Others found in small in number included P. mirabilis, P. aeruginosa, Enterococcus spp. and non-Group A-beta hemolytic Streptococcus, this accounted 2% for each. The gram positive and negative bacteria accounted 40% and 60% respectively. The susceptibility pattern for gram-negative bacteria showed that most of the isolates (> 65% of the strains) were sensitive to amoxicillin-clavulanic acid (70%), chloramphenicol (83.3%), gentamicin (93.3%), kanamycin (93.3%), nitrofurantoin (87.7%) and trimethoprim-sulphamethoxazole (73.3%). Among the gram-positives, more than 60% of the isolates were sensitive to amoxicillin-clavulanic acid (100%), cephalothin (95%), chloramphenicol (70%), erythromycin (80%), gentamicin (85%), methicillin (83.3%), nitrofurantoin (100%) and trimethoprim-sulphamethoxazole (65%). Generally, amoxicillin-clavulanic acid, chloramphenicol, gentamicin, nitrofurantoin and trimethoprim-sulphamethoxazole were effective at least in 70% of the isolates. Multiple drug resistance (resistance two or more drugs) was observed in 74% of the isolates.


CONCLUSIONS
Significant bacteriuria was observed in both asymptomatic and symptomatic pregnant women. Periodic studies are recommended to confirm the findings of this study and also monitor any changes in the susceptibility patterns of uropathogens causing urinary tract infection in the pregnant women.
Assefa
Addisu
A
Department of Biology, Science Faculty, Addis Ababa University, P.O. Box 1176, Addis Ababa.
Asrat
Daniel
D
Woldeamanuel
Yimtubezinash
Y
G/Hiwot
Yirgu
Y
Abdella
Ahmed
A
Melesse
Tadele
T
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006782:Hospitals, Special / Q000706:statistics & numerical data; D006801:Humans; D008826:Microbial Sensitivity Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D015995:Prevalence; D011446:Prospective Studies; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology*; D014556:Urine / Q000382:microbiology*; D055815:Young Adult
D000900:Anti-Bacterial Agents