Publication:

Urinary tract infections at first antenatal check-up: a single centre prospective study

Background Pregnant women with asymptomatic bacteriuria (ASB) are more likely to develop acute pyelonephritis, postpartum UTI, hypertensive disease, anemia, prematurity, low birth weight babies and prenatal death if untreated.

Methods Total 780 pregnant women attending for first antenatal check-up in a medical college were enrolled for the study. Those with any symptoms of UTI, like burning micturition, frequency, urgency, dysuria or fever were excluded from the study. All were subjected to undergo urine culture and sensitivity to the commonly used antibiotics in that area, irrespective of period of gestation, age and parity. Prevalence of ASB, most common infecting organism and antibiotic sensitivity pattern were analyzed.

Results The prevalence of ASB in 25 years age group (26.06% versus 18.80%; p = 0.020). Out of the 780 culture samples, 52 had more than 3 type colonies indicating contamination and 22 had budding yeast colonies, thus excluded from the study. No growth was found in 551 samples (78.05%). The prevalence of ASB was 21.95%. The most common organism isolated was ESBL-ve E coli (32.25%), followed by ESBL +ve E coli (21.29%) and Enterococcus (15.48%) respectively. E coli were mostly sensitive to nitrofurantoin, amikacin and cotrimoxazole whereas enteroccocus was sensitive to vancomycin.

Conclusions ASB is more common during pregnancy even in first antenatal check-up. We suggest routine urine culture and sensitivity during first antenatal check-up to detect ASB and treat with proper antibiotic to prevent the complications and development of resistance.