Asymptomatic bacteriuria in pregnant Nigerian women at the Lagos University Teaching Hospital, south west Nigeria

Background: Dipstick urinalysis is a handy and cost effective method for the early detection of asymptomatic bacteriuria. Asymptomatic bacteriuria occurs in 2-10% of pregnancies and has been associated with low birth weight and preterm delivery in pregnant women if untreated. Objective: To determine the incidence of asymptomatic bacteriuria in pregnancy, the distribution of infecting organisms and the antibiotic sensitivity pattern in pregnant Nigerian women attending the antenatal clinic of the Lagos University Teaching Hospital, Idi- Araba, Lagos. Methodology: This was a prospective study. The study population were 201 consecutive asymptomatic pregnant women, who attended the antenatal clinic of LUTH for booking between 1st July and 31st December, 2021. Two consecutive urine samples were collected and analysed for microscopy, culture and sensitivity and urinalysis. The outcomes of interest were prevalence of asymptomatic bacteriuria at LUTH, bacterial isolates, and their antibiotic sensitivity pattern. Results: The mean age of the population studied was 31years ± 4.56SD. The mean gestational age was 23.8 ± 5.39 SD with a range of 11-34 weeks; and majority of the participants (65.7%) were recruited at gestational ages between 14 and 26 weeks. The prevalence of asymptomatic bacteriuria in this study was 13.9%. The commonest isolated organism was klebsiella (46.4%) followed by Escherichia coli (21.4%). Ceftazidime, ofloxacin, and gentamycin showed good overall sensitivity with 92.9%, 89.3%, and 67.9%% respectively. From the results of urinalysis, nitrites showed a sensitivity of 48.3% and specificity of 98.2% with a positive predictive value of 83.3% while presence of bacterial cells on urine microscopy showed sensitivity of 31.2%, specificity of 85% and a positive predictive value of 27%. Conclusion: The incidence of asymptomatic bacteriuria in this study was considerably high and therefore, there may be need to consider introduction of routine urine culture at booking or in the second trimester.