Determinants and bacteria associated with asymptomatic bacteriuria among women attending antenatal care service at muhoza health centre, Rwanda

Abstract

Introduction: Asymptomatic bacteriuria (ASB) is a global health concern during pregnancy. It accounts for 2%–15% of pregnant women globally. This study was carried out to determine the prevalence of ASB, the leading cause of ASB during pregnancy, and the antibiotic susceptibility pattern of bacteria associated with ASB. Materials and Methods: This was a cross-sectional study conducted from September to December 2021 at Muhoza Health Centre. About 142 pregnant women without symptoms of urinary tract infections were recruited. The urine sample collected was put in a sterile Stuart plastic container and transported to INES Ruhengeri clinical microbiology for bacterial identification. The structured interview was conducted to assess factors associated with ASB among women. Logistic regression analysis was performed to test the relationship between demographic characteristics and ASB, while a Chi-square test (x2) was performed to test for association with ASB and other determinants considered in this study. Results: About 70.40% of participants had ASB. Pregnant women in the second trimester (28.16%) and first trimester (25.35%) were the most affected, while women aged 24–29 (28.16%) were the most affected. Escherichia coli (27.6%) and Klebsiella pneumonia (23.8%) were the predominant isolated bacteria in the urine and was observed to be the most coloniser of the urinary tract throughout all the pregnancy trimesters. Among demographic characteristics, urban residence (P = 0.005, 95% confidence interval [CI]: 0.717–4.160), primary education (P < 0.00001, 95% CI = 15.390–19.310), ordinary education (P < 0.00001, 95% CI = 16.550–20.455) and advanced level education (P < 0.00001, 95% CI = 17.194–20.650) were statistically significant to contribute to ASB. Hygiene (x2 = 6.81, P = 0.009) was significantly associated with ASB. K. pneumonia and Staphylococcus saprophyticus were the most resistant bacteria to selected antibiotics. Conclusion: ASB may be an epidemic in pregnancy. Early diagnosis of ASB is recommended in early pregnancy to prevent pregnancy-associated complications.